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

Member of VDH and FCI

Application for Membership in the BCD

I apply for a membership in the Briard Club Deutschland e.V. as:

		yearly fee:
	full member	EURO 62,00
	full member without UR (monthly VDH magazin)	EURO 54,00
	student (with written confirmation, up to age 26)	EURO 30,00
	family member *	EURO 15,00
	We will levy an admission fee of	EURO 25,00

Fields with a red star are mandatory!
First Name:	*
Name:	*
Street Address:	*
ZIP code:	*
City:	*
Country:	*
Telephone:	*
Fax:
e-Mail:
Family member of *
Date of birth:	*
I own a dog:	YES NO
Name of the dog:
Breeder of the dog:

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

I accept this form und confirm it by repeating my name.
Acceptance:	*

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