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If you wisch to become member of the Association, print this form and send it to the following address : 

Name :  .......................................................................................

First name :   ................................................................................

Occupation : .................................................................................

e-mail :        .....................................................................

Address :    ..............................................................................

Postal Code :    ............................................................................

Town :    .....................................................................................

Annual participation = 20 €uros

 Here enclosed cheque : Association LC Maillard
CCP NANCY 66 46 49 X 031