VSCZ membership

VSCZ: Membership Application Form

To apply for membership please complete the details below.
Name*

First NameLast Name
E-mail*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number
MEMBERSHIP (CHF 100 / YEAR)*

I will be happy to contribute occasionally to the group programs (active member)I don't want to contribute to the group programs (ordinary member)
payment method*

Bank TransferOrange payment slip (ESR)Cash payment at the Meeting
Should be Empty:

VSCZ: Membership Application Form