Membership application form


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I, the undersigned, wish to become a member in the Zerbst Castle Preservation Trust e.V. In so signing, I agree to recognise and accept the Trust Charter and the contribution stipulation.

Personal details:

 
  Family name: . . . . . . . . . . . . . . . . . . . . . . . . .
  First name: . . . . . . . . . . . . . . . . . . . . . . . . .
  Street: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .     . . . . .
  Zip code and place: . . . . .     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
  Telephone: . . . . . . . . . .
  E-Mail: . . . . . . . . . . . . . . . . . . . . . . . . .
  Date of birth: . . . . . . . . . .
  Occupation: . . . . . . . . . . . . . . . . . . . . . . . . .
  Membership from: . . . . . . . . . .



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Place, date

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Signature