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MEMBERSHIP FORM
Undersigned
Surname Name Address n° Zip Code City Province Region Nazion Home phone No. Fax No. Cell phone No. E-mail
I hereby wish to become a member of
A.D.ES. Associazione AMICI e DISCENDENTI degli ESULI Giuliani, Istriani, Fiumani, Dalmati
For the year 2007. I also hereby accept the Association Statutory purposes.
I undertake to pay the membership fee of € 10,00 ordinary15,00 supporters
postal giro account 36279305 in the name of
ADES Presso Comitato Prov.le ANVGD Trieste Via Milano 22 34122 TRIESTE (TS)
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