become a membre
  

 

To become a membre of the ROMA association

 

  • Annual subscription : 39 €
  • Annual subscription for a couple : 55 €

Subscription includes the subscription to the review Volumen and give right of a reduction when you take part in a lecture, a course or a trip of the association. Validity : One year become when we recieve the payment.

  • Alternative annual cotisation for students (<26) : 25 € (it doesn't include the subscription to the review)

 

Please fill this form and send it to info@roma-asbl.be, or by post to ASBL ROMA, Rue du paradis 10, 1348 Louvain-la-Neuve (Belgium)

INSCRIPTION FORM 

ASBL ROMA

 

NAME :…………………………………………………………………………………………....

FIRSTNAME :…………………………………………………………………………………….

ADRESS :……………………………………………………………………………………......

…………………………………………….……………………………………………………....

E-MAIL :…………………………………..………………………………………………............

 

Want to become a membre :

  • et pay subscription : 39 €
  • et pay subscription : 55 € (couple)

NAME ET FIRSTNAME OF THE SECOND MEMBRE OF THE COUPLE :

…………………………………………………………………….......................................

 

  • et pay subscription : 25 € (only students <26)

 

to the account number 363-0318988-92

IBAN : BE12 3630 3189 8892

BIC : BBRUBEBB

 

 

Date and sign :

 

© 2011