To become a member of the Association or to renew your subscription please print and complete the following form. Send it with your payment (cheque or money order) to the Association l'Association "Les Amis d'André Jolivet" - 22, rue Richer, - F-75009 Paris

Print the membership form :

Membership form :

I, the undersigned, Mr, Mrs, Miss: ..............................................................

Adress : .......................................................................................................

Postal code: ............. Town: ........................Country:.................................

Telephone number: ............................. E-mail adress: ..............................

- hereby apply to become a member
- request that my membership subscription be renewed:
"Les Amis d'André Jolivet"
(check the applicable case)

   benefactor member: above 76 €

   active member: 23 €

   adherent member and Student: 11,5 €

and for this, I attach to this form a cheque of an amount of € :.......... worded as follows: "Les Amis d'André Jolivet"