Online membership

Online membershipPartner membership

Please fully complete this form, a tax receipt will be sent upon reception of your friendly settlement.

 

Where the contribution is supported by your employer, please indicate all the details of the person in charge of monitoring and regulation

Amount of the contribution : 50 euros (tax-free). Bank transfer :
Crédit Agricole Brie Picardie
Code Banque : 18706 – Code Guichet : 00000
N° Compte : 72180867599 – Clé : 76
IBAN : FR76 1870 6000 0072 1808 6759 976
Code BIC – Code swift : AGRIFRPP887

Please fully complete this form, a tax receipt will be sent upon reception of your friendly settlement.

 

The company will be represented by

Amount of the contribution : 400 euros (tax-free). Bank transfer :
Crédit Agricole Brie Picardie
Code Banque : 18706 – Code Guichet : 00000
N° Compte : 72180867599 – Clé : 76
IBAN : FR76 1870 6000 0072 1808 6759 976
Code BIC – Code swift : AGRIFRPP887