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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:

Margret Embry (EPU Treasurer)
De Peuthystraat 62, B-3040 Huldenberg, Belgium
Email: margret@tewes.be

FEES SHOULD BE PAID TO:
KBC Bank, B-3040 Huldenberg/Brabant, Belgium
Ac no. 734-0268379-86
IBAN: BE78734026837986
BIC: KREDBEBB
Name of account holder: European Polio Union

 

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