Become a member

Application form for EGWA 'S membership
Name of the organisation :
Address :
postal code :		City :
Country :
Phone number (including international code)
Fax number (including international code)
E-mail :
Internet home-page :
Name and title of contact person
Name and title of second person (suppleant)
Your organisation applies for
Full membership Supporting member
Please state the purpose of your organisation
Structure of your organisation (Foundation, Federation, Non profit association, Firm, Governmental body,...)
Number of members (or groups)
Do you want to receive the mail at the above address ?
Yes No, send it to :
Which language would you prefer for your mailing ?
French English
Date :	23/05/2013