HOME

BACK NEXT

FORMULARZ DEKLARACJI CZŁONKOWSKIEJ FUNDACJI KRÓLOWEJ JADWIGI

(THE QUEEN JADWIGA FOUNDATION)

Aby zostać członkiem The Queen Jadwiga Foundation proszę wypełnić podany formularz i wysłać wraz z opłatą członkowską na adres:

The Queen Jadwiga Foundation

P.O. Box 654

Toorak 3142

Victoria

Level of Membership (*): ------------------------------

Nazwisko i imie: --------------------------------------------------------------------------------------

Podpis: ------------------------------------------------------------------------------

Adres: ------------------------------------------------------------------------------

------------------------------------------------------------------------------------------------

Miejscowość: ------------------------------------------------------------------

Kraj: ------------------------------------------------------------------

Telefon: ----------------------------------------------------------------

E-mail: ----------------------------------------------------------------

(*) Level of Membership (select one):

Royal family member - (by invitation only)

The QJF Council Honorary Member - (by invitation only)

Regional Office Chairman - (by invitation only)

The QJF Council Associates - (by invitation only)

The QJF Advisory Council Associates (must hold PhD degree) - $100 and up

Chairman’s Club - $5,000 and up

Founder’s Club - $1,000 – 4,999

Patron - $500-999

Benefactor - $250-499

Member - $100

Associate - $50

Student - $25