English
Roger TOULOUSE
Orleans (1918-1994)
Painter, sculptor,
illustrator and poet
Entry form

Call for contributions


                                First registration                or                  Renewal                 
 

Name : Ms, Mrs, M   ............................................ First name  ....................................


Address .....................................................................................................................


Phone  ........................................   Email address  ......................................................



Wants to register to the association « Les Amis de Roger Toulouse ».

 


Please choose your annual contribution :

1 - Student : 8 €

2 - Basic contribution : 25 €
3 - Second contribution in the same household : 20 €

4 - Support contribution : 45 €

5 - Benefactor member : from 60 €

 

This payment gives you a tax reduction equal to 66% of the contribution (for French resident).
(Tax certificate will be sent at the end of the year)
 

 

Form and cheque payable to the association to be sent to the treasurer :
Catherine CHÊNE
 : 13, place de la Commune - Saint Jean de Braye - 45800 - France (Tél : 00 33 238 216 306)

The Friends 
of Roger Toulouse

pt_0_logo_art_recadre

 

download the form
entry_form.doc (27 KB )

 

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