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Tilmeldingsblanket til kor i DASOM

 

Korets navn___________________________________________

 

Antal kormedlemmer____________________________________

 

Blandet kor_____ Damekor_____ Mandskor_______

 

Formand

Navn________________________________________________

 

Adresse______________________________________________

 

By__________________________________________________

 

Tlf.______________________mobil_______________________

 

Mail_________________________________________________

 

 

Kasserer

Navn________________________________________________

 

Adresse______________________________________________

 

By__________________________________________________

 

Tlf.______________________mobil_______________________

 

Mail_________________________________________________

 

 

Dirigent

Navn________________________________________________

 

Adresse______________________________________________

 

By­­­­­­­­­­­­­­­­__________________________________________________

 

Tlf.______________________mobil_______________________

 

Mail_________________________________________________

Kontingent overføres til DASOMs  bankkonto i Nørresundby Bank
reg. nr. 7459 kontonr.: 0001018531.  

Kontingent udgør pt. kr. 65, – pr. år.

Blanketten indsendes til:Tove Jensen, Lupinmarken 56, 8800 Viborg eller vedhæftes e-mail til Denne e-mail adresse bliver beskyttet mod spambots. Du skal have JavaScript aktiveret for at vise den.