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
Abbaye St. Pierre, 1 place Dom Guéranger
F-72300 Solesmes

Donations may be sent by check (to the Association), or by electronic transfer to:

Crédit Mutuel Pays Sabollen, Allée Raiffelsen. BP 147
F-72303 Sablé sur Sarthe Cédex, France

IBAN: FR 76 1548 9048 2100 0692 1080 167