Briardclub Deutschland e.V. - Informationen über den Briard – Züchter – Welpen

Member of VDH and FCI

Subscription of the Briard-Revue

I wish to subscribe for the Briard-Revue:

		yearly fee:
	Subscription of the Briard-Revue inside Germany (only for members of other Briard clubs acknowledged by the FCI)	EURO 30,00
	Subscription of the Briard-Revue outside of Germany	EURO 35,00

Fields with a red star are mandatory!
First Name:	*
Name:	*
Street Address:	*
ZIP code:	*
City:	*
Country:	*
Telephone:	*
Fax:
e-Mail:
Date of birth:	*

Direct debit authorization:
Account number:
Bank code:
Name of Bank:

I accept this form und confirm it by repeating my name. Further I confirm that I am member of another Briard club acknowledged by the FCI (does not apply to other countries than Germany).
Acceptance:	*

If you wish to print an application and send it via fax or mail