Fillable Community Impact Bundle Activation Fr (Optimist International)

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Community Impact Bundle Activation Fr (Optimist International)

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FORMULAIRE D’ACTIVATION
Les clubs Optimistes doivent utiliser ce formulaire pour activer les adhésions individu-
elles Ami des Optimistes qui sont incluses dans l’ensemble Impact sur la collectivité. Un
formulaire est requis pour chacun des six membres inclus dans l’ensemble.
Formulaire d’activation de l’ensemble Impact sur la collectivité 2015-2016
Est-ce que cette activation est un cadeau? Oui Non
Nom de club : Numéro de club :
Nom de l’ami à activer :
Adresse :
Ville : Province : Code postal :
Numéro de tél. à domicile : Courriel :
(ADRESSE DE FACTURATION SI DIFFÉRENTE)
Adresse :
Ville : Province : Code postal :
Parrainé par un club Optimiste (le cas échéant) : Membre :
Renvoyer à : Optimist International ∙ 5205, boul. Métropolitain Est, bureau 200 ∙ Montréal, QC H1R 1Z7 ∙ FAX : 514-721-1104 ∙ service@optimist.org
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Community Impact Bundle Activation Fr (Optimist International)

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Completed 24 July 2020

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