Association des Amis du Salon d'Automne de Paris

**Association des Amis du Salon d’Automne de Paris**
Renewal / Membership for 2010

Title (Mrs., Ms., M.)
Surname
Name
Address
Post code
Town / City
Country
Telephone
e-mail
Cost of joining the Association of Friends of the Paris Salon d’Automne in 2008 — 130 Euro
Donation for the Association of Friends of the Paris Salon d’Automne for 2008
Total Euro
.DateLibellé.....
Signature

Please fill out this form, print it and send it, along with payment by check or money order, to:
Les Amis du Salon d'Automne de Paris
28 avenue Perrichont 750016 Paris
Phone +33 (0)6 83 83 81 83