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Sign-up form for Membership of the Association Wild Roots (Verein Wilde Wurzeln)
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Email
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Your email
family name
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first name
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title
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birth date
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profession
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street
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postal code, city of residence
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country of residence
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phone
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I heard of association wild roots through:
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I want to join as
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simple member (membership fee 20€ annually)
organizer member (membership fee 70€ annually)
All-In member (240€ annually)
I thereby ensure to pay the membership fee to the following bank or paypal account
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annually
semi-annually
Accounts
Bank:
account holder: Verein Wilde Wurzeln
IBAN: AT79 1420 0200 1097 3970
BIC: BAWAATWW
Paypal:
office@wildewurzeln.at
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With sending this form I accept the privacy policy and terms and conditions of Verein Wilde Wurzeln
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The membership can be cancelled semi-annually.
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