Membership Form
Association for the Beatification and Canonization of Empress and Queen Zita, Wife and Mother
Mr./Mrs./Ms/Title: ______________________________ Last Name: ______________________________ First Name: ______________________________ Address: ______________________________ City: ______________________________ State/Province: ______________________________ Zip/Postal Code: ______________________________ Country: ______________________________ _____ I wish to join the Association as: Benefactor Membership: € 50 and above Regular Membership: € 20* * The amount is according to whatever each person can afford _____ I wish to make a donation to the Association We ask that you forward to us the names and contact information of others who may be interested in this Cause. The Association will not share this information with anyone else. Thank you for sending your membership to the Association: Ass. pour la beatification et la canonization de l’impératrice et reine Zita Donations may be sent by check (to the Association), or by electronic transfer to: Crédit Mutuel Pays Sabollen, Allée Raiffelsen. BP 147 BIC: CMCIFR 2A
Abbaye St. Pierre, 1 place Dom Guéranger
F-72300 Solesmes
France
F-72303 Sablé sur Sarthe Cédex, France
IBAN: FR 76 1548 9048 2100 0692 1080 167