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Application Form

Word Document Download the European Membership Form (Word format, 46KB)

PDF Document Download the European Membership Form (PDF, 156KB)

PLEASE RETURN THIS FORM TO:

Daniel Peltzer (EPU Treasurer)
c/o Association Belge des Paralysés a.s.b.l.,
Chaussée de Gand 1434,
à 1082, Bruxelles (Berchem Ste-Agathe),
Belgium

Email: dpeltzer@abpasbl.be

 

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