ESFR Registration and Feedback Form for Sponsoring Individual Membership

I am interested in supporting the ESFR and I want to become a sponsoring individual
member. I will transfer the membership fee of 500 EURO to the ABN-AMRO bank
mentioned below until one week after registration.

ABN-AMRO Bank Nijmegen
Account Number: 54 11 01 935
Name of the holder: European Society on Family Relations
BIC Code: ABNANL2A IBAN: NL34ABNA0541101935

Please select*:Mr.Mrs.
Last Name*:
First Name*:
Affiliation:
Pleasen indicate*:private addressinstitutional address
Street*:
City*:
Postal code*:
Country*:
Phone:
Fax:
email:
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