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Membre passif / Passivmitglied
Veuillez remplir ce formulaire afin de vous inscrire en tant que membre passif du SMOMS.
Bitten füllen Sie dieses Formular aus um Passivmitglied werden zu können.
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Nom / Name
*
Your answer
Prénom / Vorname
*
Your answer
Rue / Strasse
*
Your answer
Code postal / Postleitzahl
*
Your answer
Ville / Stadt
*
Your answer
E-mail
*
Your answer
Montant en CHF / Beitrag in CHF
*
Montant souhaité pour votre participation, par exemple 100 | Von Ihnen frei wählbarer Betrag (beispielsweise 100)
Your answer
Remarques / Bemerkungen
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Type this code: TMXU3
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This code is to verify you are a human. Protected by xfanatical.
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