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Join Petra Viva
the association for the defense and promotion of the Pietracorbara valley

SURNAME |

First name |


Address |

Post code/ ZIP |

Country |

E-mail |

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__ __ __ __ __Town_____________

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I wish to join Petra Viva

as the following type of member:

 member: 10 euros
donor: 38 euros
sponsor: 76 euros or more

Please find attached a cheque for the sum of __________

for the year ________.

Signature

Please print and send the membership form to:

Christian ZANETTACCI
Trésorier de Petra Viva
Lapedina
20233 PIETRACORBARA