LYMEC asbl :: European Liberal Youth

Sections index > LYMEC Individual Membership > Individual Membership Online Application form

LYMEC Individual Membership

Online Application Form

NB: Please note that membership is valid for the remainder of the calendar year in which you made the payment.

Family name:		First name
Nationality		Birth date

Street
Postal code
Town
Country
Telephone
Mobile phone
Fax
E-mail
Personal website
LYMEC Member Organisation (if any)
User login at lymec.org
Main political interests	(you can select several fields by pressing CTRL)
Political competences	(you can select several fields by pressing CTRL)

MEMBERSHIP

I apply for:

1 year membership (10 euro)	5 years membership (35 euro)	Lifetime membership (90 euro), valid until 35 y.o.
I am already a paid-up individual member and only wish to update my personal data

I will pay my membership fee by:

Payment card (VISA or MasterCard)

Credit transfer

already paid / other:

(if payment by card, please pay before validating this application form. Click now on the option above and a new window will open)

INDIVIDUAL MEMBERS' "WHO's WHO?"

I authorise LYMEC to disclose my personal details to other Individual Members (in order to enable them to contact me, e.g. in the case of events or working groups):

YES NO

Personal data will not be disclosed to third parties.

LAST BUT NOT LEAST:

To weed out spam-bots, please type YES into the following field: Are you a human?

Thank you for taking the time to answer the questions!

ELDR Focus Year