MEMBERSHIP FORM 2003

ASSOCIATION


Required information:
SURNAME : ..................................................................................................
FIRST NAME : ..............................................................................................
STREET : .....................................................................................................
POSTAL CODE: ...........................................................................................
TOWN : ........................................................................................................
STATE OR PROVINCE : ..............................................................................
COUNTRY : ................................................................................................
H-VAN(S) OWNED AND YEAR(S) : .........................................................

Optional information:
TELEPHONE (VOICE) : .............................................................................
FAX : ...........................................................................................................
MOBILE/CELL : ..........................................................................................
E-MAIL : ....................................................................................................

2 TYPES OF MEMBERSHIP :
  • ACTIVE MEMBER : 20 € (annual dues)
  • SUSTAINING MEMBER : 20 € (annual dues) + 20 € (sustaining dues)
    for a total of 40 €

THE OFFICERS OF THE ASSOCIATION ARE :
  • 1 President : Bruno DELTOMBE
  • 1 Vice-President : Gilles COINCHELIN
  • 1 Treasurer : Fabrice PUAUD
  • 1 Secretary : Roald DOBRILLA

GOALS OF THE ASSOCIATION :
  • preserve Citroën H-Vans;
  • create friendly and helpful ties among those who admire these vans;
  • assure the promotion of the H-Van;
  • attend gatherings with our vans as often as possible;
  • help those who admire H-Vans in restoring their vehicles (technical advice, within the limits of our own knowledge base, Citroën technical documents and others, rental of special tools, ...)

Send this form to :
Les Amis du Type H, 16 rue du Bel Air, 93700 Drancy, France