La Société des Amis de Arnold Dolmetsch
Mr. Mrs Miss, Ms
... Address : ... e-mail : Telephone / fax : Profession : Would like to become a member of Société des Amis de Arnold DOLMETSCH 9 pl. de Hallai 72000 LE MANS
and encloses a subscription of 20 euros (active members) ; or 150 euros (as a benefactor).
date and signature
M. Avice trésorier