MEMBERSHIP APPLICATION

Please complete using a computer or word processor
(handwritten documents are not acceptable)
Photo
 Family and first names:
Nationality:
Full Postal Address:
Phone number:
Fax number:
Mobile phone:
E-mail Address:
Website:
Spoken and written languages:
RDP: /
Member of the following PHILATELIC organizations (and your title): e.g. RPSL (Fellow), Académie de Paris (m.c.), AEP (treasurer), etc…:
Other positions and responsibilities in the philatelic sector:
Principal collections and areas of interest:
Philatelic rewards (where and when obtained):
Publications:
Attached: Reports submitted by the Proposer and Seconder.