Membership form for the German Apitherapy Society

Karl-Postl-Str. 14 80937 Munich, Germany.
Phone: + 49-89/21 98 1061. Fax: + 49 - 89 – 2198 - 05 – 1061.
Email: drstangaciu@apitherapie.de www.apitherapie.de

Bank: Sparda-Bank Munich. BLZ: 700 905 00. Account #: 3297780.

IBAN: DE20700905000003297780 BIC (Swift-code): GENODEF 1 S 04

First name: ..............................................................................

Family name: .................................................................................

Profession/occupation: .................................................................................

Street: .................................................................................

City, postal code, country: .................................................................................

E-mail: .................................................................................

Phone, Fax #.: ..................................................................................

I confirm here below with my signature that I want to join the German
Apitherapy Society.
I agree to send the membership fee in value of 50, 00 € + 5, 00 € (as one-time application processing fee).

I sent the membership fee through:

a) Wire transfer, directly from my bank account number……………………
or

b) Bank draft (check) to: “German Apitherapy Society (membership fee)”.

Place, date and signature: ................................................................

N.B. To speed the processing of your application we suggest you go through the following steps:

• Step One: edit the above application form with all your personal details;
• Step Two: contact your bank people than send us your membership fee;
• Step Three: make a copy of the bank payment document and send it to us together with your above application form.

We suggest you send us all your documents by Fax or better, if possible, by E-mail (as scanned „jpeg“document (maximum size, please, 60-80 Kbytes).

Please keep in mind that the renewal of your future membership fees (50, 00 €) are to be made each beginning of year in January.

Thank you in advance!

Dr. Stefan Stangaciu,

President of the German Apitherapy Society