PINSCHER CLUB MEMBERSHIP FORM

Fill in, print and sign this form, and send it by fax to: 91 637 17 13

First Name:
Second Name:
Name:
Passport nº:
Address/nº:
Town:
Zip Code:
Province:
Country:
Telephone:
Fax:
e-mail:
Web:
Affix name:
Affix nº.:
I request to be accepted for Pinscher Club membership.
I accept the rules and I make known that all details on this form are true.
Signature:
 
Member who introduces me:
Member nº:
Name
Signature:  
 

Accepted finally as a member, Committee meeting dated:
President Signature:

 

Protection data law:

  
I agree to receive publicity:
YES NO
I accept to give my details for future electoral campaigns of Pinscher Club:
YES NO