REQUEST FORM

for membership of the Perfin Club Nederland.

Please first read the notes: click here.

Requestform

First name

Preposition

Last name

Sex

MaleFemale

Email address

Address

Postcode

City

County

Phonenumber

Date of birth

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Bank account

Wants to be member after (date)

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Receive mail
(only available in The Netherlands)

Yes No

Placed on tradinglists

YesNo

Want tot receive PCN members tradinglist

YesNo

I want to receive older editions of Perfinpost € 2,30 +postage

YesNo

Want to receive list of publications and catologs on Perfins

YesNo

My collection Interest are

Comments

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