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: proartedenia@gmail.com
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.