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Application Form

Association de la Presse Anglo-Américaine de Paris

 

Membership Application Form

 

Name……………………………………………………………………………………

 

Nationality………………………………………………………………………………

 

Email……………………………………………………………………………………

 

Home address…………………………………………………………………………

 

Fixed phone……………………………………………………………………………

 

Mobile…………………………………………………………………………………..

 

Media/Publication……………………………………………………………………..

 

Position…………………………………………………………………………………

 

Office address…………………………………………………………………………

 

Date…………………………………………………………………………………….

 

Signature……………………………………………………………………………….

 

Names of TWO sponsors who are ACTIVE members (both sponsors must

themselves email Sec Gen Cathy Nolan at catherine.nolan0860@orange.fr to

confirm their sponsorship):

 

1.………………………………………………………………………………………..

 

2…………………………………………………………………………………………

 

This application, when completed, should be mailed or emailed to:

 

Mme. ALOISI Maria-Vicenza

34 rue de Penthièvre

75008 Paris

 

angloamericanparis@gmail.com

 

…………………………………………………………………………………………..

PLEASE LEAVE THE SPACE BELOW BLANK

Received ………………………………………………………………………………

Submitted to the Committee …………………………………………………………

Action taken: Elected to ACTIVE Membership

Elected to ASSOCIATE Membership