BLC ~ Social Networking for the English Speaking Community Membership Application Form

British Ladies Club of Luxembourg (BLC)
B.P. 57,
L-6905 Niederanven
Luxembourg

www.blc.lu

Member Information

Annual membership fees for the club is 32 EUROS or 20 EUROS for new members only joining between January and May.

Our membership year runs from June 1st to the following May 31st.

Previous BLC Members and renewing members are NOT entitled to the half price discount indicated above. The 20 Euros price is only for brand new members joining the club between January and May of the club year. All full price subscriptions are due from the end of May and you will be informed of this by the membership secretary via the club newsletters.

Payment to be made as soon as possible to the following account:

British Ladies Club Luxembourg
BCEE IBAN LU06 0019 2855 9484 8000

with ref: BLC Membership 2011/2012 and please state your name here also if different to account holder.

Please do not send us cheques, bank transfer by virement or internet is preferred.

Membership is not valid until completed form and payment has been received and acknowledged by the membership secretary

Please fill in all required fields below marked with a *.

* Surname

* First Name

* Street Address

Address Line 2

* Town

* Commune

* Postal Code

* Country

* Email Address, (please make sure that this a valid address and that your spam shield will not be blocking the response)

* Contact Phone Number

Mobile Phone Number if applicable

* I have paid 32 EUROS for ANNUAL membership/ to renew my membership
please note, renewing members are not entitled to a reduction

Yes

No

* I have paid 20 EUROS as a NEW MEMBER joining between January and May.

Yes

No

* Membership Type

New Member

Renewing Member

Change of address or other contact details

* When did you arrive in Luxembourg? (month/year)

* Your Nationality

* Decade Born

Languages spoken

French	German	Luxembourgish
Other

Can you drive?

Do you work outside of the home?

Number of children

mm yy of birth

Which school do they attend?

Would you be willing to help organise Club activities?

How did you hear about the BLC?

* I have read and agreed with the terms and conditions.

Yes

* Indicates Response Required