ASOCIACIÓN MULTICULTURAL PRO ARTE DÉNIA Declaration of accession            Nr. First name:                     Last name: Nationality: Address: Phone: E-mail: Date of birth: I accept the statutes of the association (available as PDF file at any time) and accept the one-time entry fee of 20 Euro as well as the annual fee of 30 Euro, valid from January 1 to December 31 of the current year. Date: Signature: Official address of the association: Carrer Ametla 1B                                               03700 Dénia President: Teresa Juan López Phone: 609 92 22 32 e-mail: Bank details: Caja Rural de Soria ES 85 3017 0111 7321 9232 2119 Account holder: Pedro E. Blasko Reason for payment: Pro Arte Dénia Data protection: The association guarantees the data protection of each member. A passing on to third parties is excluded.