Membership Registration Form

PERSONAL DETAILS

Membership

New

Renewal

Membership Number (only for renewal)

First Name

Last Name

Nationality

Sex

Female

Male

Age

Less than 30

Over 30

Date of birth if less than 30 years old

Street Address

City

Postal Code

Country

Mobile Phone (ex.+352 000 000 000)

Email Address

Preferred Language

English

French

Italian

German

Spanish

Membership Type

Individual (1 year) : 50€

Individual (1 year) - Couple option : 65€

Individual (3 years) : 140€

Individual (3 years) - Couple option : 185€

Sustainer (1 year) : 100€

Sustainer (1 year) - Couple option : 115€

Young (under 30 years old) : 25€

Young (under 30 years old) - Couple option : 40€

DETAILS OF COUPLE MEMBERSHIP (only for Membership with "Couple option" )

First Name

Last Name

Sex

Female

Male

Email Address

Notes

Privacy

In accordance with Regulation (EU) 2016/679 (GDPR) regarding the processing of personal data, I hereby grant permission for the use of my personal information for Slow Food association purposes and activities. More information can be found at the Privacy Policy link at the bottom of the website page.

PAYMENT INSTRUCTIONS : By bank transfer to SlowFood Grand-Duché Asbl using the bank details set forth below.

SFG-D Bank Account Number (IBAN)

SFG-D Bank Account BIC / Swift Code

Communication

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The Privacy Policy applies.

Note: Please fill out the fields marked with an asterisk.