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Zerbst Castle Restoration Trust e.V.
Markt 6

D-39261 Zerbst/Anhalt





Request for membership in the Zerbst Castle Restoration Trust e.V.

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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