Subscription

Name:

First name:

Is company? Do you manage a non profit organization, or a company? If you do so, check the box, and then enter its name in the field that will appear.

Company:

Nickname:

Title: Not supplied M. Mme. Mlle

Birth date: (yyyy-mm-dd format)

Gender: Unspecified Man Woman

Profession:

Language: Deutsch English Français

Other informations:

Username: (at least 2 characters)

Password: A link will be sent to you if you have provided an email address. Otherwise, you can use this password to login, and we recommend you to change it as soon as possible. Please repeat in the field the password shown in the image.

Be visible in the members list: If you check this box (and if you are up to date with your contributions), your full name, website address ad other informations will be publically visible on the members list.
If you've uploaded a photo, it will be displayed on the trombinoscope page.
Note that administrators can disabled public pages, this setting will have no effect in that case.

Address:
Address (continuation)

Zip Code:

City:

Country:

Phone:

Mobile phone:

E-Mail:

Website:

Comment avez vous connu le club ? (not translated) Select an option PRESSE AUTRE MEMBRE INTERNET AUTRE

Avez vous déjà été membre ? (not translated) Select an option non oui