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Deutsche Wolfsgemeinschaft						
German Wolf Association e.V.                     Membership Application Form
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Herewith I apply for a membership at the Deutsche Wolfsgemeinschaft /
German Wolf Association e.V. 

[ ] Name:        ___________________________________________________________
 
[ ] First Name:  ___________________________________________________________

[ ] Address:     ___________________________________________________________

[ ] ZIP/City/State: ________________________________________________________

[ ] Country:     ___________________________________________________________

[ ] Phone/FAX:   ___________________________________________________________

[ ] Birthdate:   ___________________________________________________________

[ ] Occupation:  ___________________________________________________________

[ ] E-Mail:      ___________________________________________________________

[ ] Web address: ___________________________________________________________


  My annual membership fee amounts to:


  [ ]  36 EUR ($40)	[ ]  18 EUR ($20)	[ ]  ___________ EUR
       Regular fee        Reduced fee	        "Alpha" (36+ EUR)

  [ ] Please make my name, first name and email address available for other 
  members to see in the restricted member‘s area. (You can make more of your 
  data available later by logging in)


  [ ] Please send a receipt




  _______________________________________________________________________
  Date	                  Signature	            Signature of a parent
                                               (if applicant is underage)


German Wolf Association, Am Stege 43, 34123 Kassel, Germany
Banking details: Volksbank Gießen
                 Account no.: 10 5222 00, Bank code: 513 900 00
                 IBAN: DE08 5139 0000 0010 5222 00
                  BIC: GENODE51GI1