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Hana Chapter of Belgium

Ikebana International Hana Chapter of Belgium #248 asbl

Application form 2011-2012
   
Name:
First Name:
Birthdate
Nationality
Address
Postal code
City
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GSM
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Ikebana School:
Correspondence language (Eng,Fr,Nl)
   
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ANNUAL FEE : 75,00 Euros payable before the end of August 2011
to bank account
ING 310-0975585-45      IBAN BE44 3100 9755 8545           BIC BBRUBEBB
Ikebana International Hana Chapter of Belgium