COMUNIDAD ISRAELITA DE ALICANTE

Please send the completed form to address shown below.
Por favour, retornar este formulario a la sguiente.

Membership Application Form. /Formulario para Nuevos Miembros.
(Please complete in CAPITALS) (Por favor, usa MAYUSCULOS)

NAME/NOMBRE.............................................................D of B./F DE N..../.../19.......
HEBREW NAME/NOMBRE JUDEA..............................................
ADDRESS.
DIRECCION................................................................
. .........................................................................
.........................................................................
HOME ADDRESS..............................................................
(Non-residents)...........................................................
. ..........................................................................
E.MAIL ADDRESS:...........................................................
TELEPHONE No/No de TELEFONO:.....................Mobile./Movil:................

(Tick as appropriate)...(Marcar el apropiado:)

  • I wish to apply for membership of the Comunidad Israelita de Alicante, and I enclose my Annual Subscription of:
    Family Membership: 250 euros. Individual Membership: 150 euros.

  • Solicito el ingreso como miembro en la Comunidad Israelita de Alicante, e incluyo mi suscription de:
    Familiar: 250 euros. Individuales: 150 euros.

    (Note: Annual subscriptions are renewable from 1st January each year) (Nota: El abono esta renovable de 1 Enero cada ano)

    Your application may depend upon production of certain documents and information.
    Su aplicacion puede depender de la produccion de ciertos documentos e informacion.

    Signature (Firma)___________________________Date (Fecha)_________

    Please indicate below which of the following activities are of interest to you.
    • Music appreciation (Musica)
    • Theatre Visits (Visitas al teatro)
    • Talks (Charlas)
    • Day Trips by car or coach (Salidas de un dias por coche o autobus)
    • Trips of 3-4 days to places of interest (Salidas de interes 3-4 dias)
    • Other (Indicate. / detalla)
    Please return this form to :
    Mr Rodney Shears, Buzon 126, Residencial Almunia Rafol D'Almunia 03769 Alicante.

    Membership Form (I)(S).doc Jan 07.rev.April 2011 bi



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