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<BODY text="#000066" link="blue" vlink="purple" alink="red" background=""> <A NAME="pgtop"></A> <A HREF="presentationc.htm">Table des matières</A> <A HREF="presentation4.htm"><Img Src="fllarrow.gif" ALT="Précédent" WIDTH=24 HEIGHT=24></A> <BR> <BASEFONT size=3><A NAME="pgtop"></A> </basefont><TABLE BORDER=0 CELLPADDING=0 CELLSPACING=0 WIDTH="79%"><TR> <TD> <TABLE BORDER=0 CELLPADDING=0 CELLSPACING=0 WIDTH="100%"> <TR><TD COLSPAN=0 HEIGHT="31" width="36"><span style="font-size:10pt;">5</span></TD> <td height="31" width="731"><h4 style="text-align:center;" align="center"><u><span style="font-family:Arial;">Bulletin d’ADHÉSION</span></u></h4></td> </TR> <TR> <TD WIDTH="768" HEIGHT="25" colspan="2"><p align=center style='margin-left:247.8pt;text-align:center;text-indent:35.4pt'><b><span style="font-family:Arial; font-size:12pt;">N° Adhérent : </span><span style='font-size:11.0pt;font-family:Arial;'>          </span></b></p> <p style='text-align:justify'>Vous pouvez imprimer le bulletin d'adhésion suivant et le renvoyer à <i>Huguenots de France</i> – 6A, cours de la Liberté 69003 LYON, accompagné de votre règlement.</p> <p><span style='font-size:11.0pt;font-family:Arial;'>Je soussigné Monsieur - Madame - Mademoiselle (1)</span></p> <table border=1 width="98%" cellspacing=0 cellpadding=0 style='margin-left:-2.25pt;' align="center"> <tr> <td width="374" style='width:247.45pt;padding:0cm .75pt 0cm .75pt' colspan="2"><p style="margin-left:7;"><span style='font-size:11.0pt;font-family:Arial;'>NOM :</span></p></td> <td width="252" style='width:224.15pt;padding:0cm .75pt 0cm .75pt'><p style="margin-left:7;"><span style='font-size:11.0pt;font-family:Arial;'>NOM de jeune fille :</span></p></td> <td width="252" style='width:224.15pt;padding:0cm .75pt 0cm .75pt'><p style="margin-left:7;"> </p></td> </tr> <tr> <td width="374" style='width:247.45pt;padding:0cm .75pt 0cm .75pt' colspan="2"><p style="margin-left:7;"><span style='font-size:11.0pt;font-family:Arial;'>PRÉNOM :</span></p></td> <td width="252" style='width:224.15pt;padding:0cm .75pt 0cm .75pt'><p style="margin-left:7;"><span style='font-size:11.0pt;font-family:Arial;'>PROFESSION :</span></p></td> <td width="252" style='width:224.15pt;padding:0cm .75pt 0cm .75pt'><p style="margin-left:7;"> </p></td> </tr> <tr> <td width="374" style='width:247.45pt;padding:0cm .75pt 0cm .75pt' colspan="2"> <p style="margin-left:7;"><span style='font-size:11.0pt;font-family:Arial;'>DATE de naissance :</span></p></td> <td width="252" style='width:224.15pt;padding:0cm .75pt 0cm .75pt'><p style="margin-left:7;"><span style='font-size:11.0pt;font-family:Arial;'>Lieu de naissance :</span></p></td> <td width="252" style='width:224.15pt;padding:0cm .75pt 0cm .75pt'><p style="margin-left:7;"> </p></td> </tr> <tr> <td width="755" colspan="4" style='width:471.6pt;padding:0cm .75pt 0cm .75pt; height:48.75pt'><p style="margin-left:7;><span style='font-size:11.0pt;font-family:Arial;'>Adresse :</p> <p style=" margin-left:7;"><span style='font-size:11.0pt;font-family:Arial;'>Adresse :</span></p> <p style="margin-left:7;"> </p></td> </tr> <tr> <td width="265" style='width:247.45pt;padding:0cm .75pt 0cm .75pt'><p style="margin-left:7;"><span style='font-size:11.0pt;font-family:Arial;'>Code postal :</span></p></td> <td width="375" style='width:224.15pt;padding:0cm .75pt 0cm .75pt' colspan="2"><p style="margin-left:7;"><span style='font-size:11.0pt;font-family:Arial;'>Ville :</span></p></td> <td width="252"><p style="margin-left:7;">Tél. :</p></td> </tr> <tr> <td width="755" colspan="4" style='width:471.6pt;padding:0cm .75pt 0cm .75pt'><p style="margin-left:7;"><span style='font-size:11.0pt;font-family:Arial;'>Courriel :</span></p></td> </tr> <tr> <td width="755" colspan="4" style='width:471.6pt;padding:0cm .75pt 0cm .75pt'><p style="margin-left:7;"><span style='font-size:11.0pt;font-family:Arial'>Site web :</span></p></td> </tr> </table> <p><span style='font-size:11.0pt;font-family:Arial;'>Déclare :</span></p> <ul type="disc"> <div align="left"> <li><table border=1 cellspacing=0 cellpadding=0 width="90%"> <tr> <td><span style='font-size:11.0pt;font-family:Arial;'>- Adhérer à l’association <i>Huguenots de France</i> pour l'année 2005 et verse (2) la somme de <b>10</b> € représentant le montant de ma cotisation pour l'année 2005. La cotisation couvre l'année civile, quelle que soit la date d'adhésion.</span></p></span></td> </tr> </table></div> </ul> <ul type="disc"> <li><span style='font-size:11.0pt;font-family:Arial;'>Je suis déjà adhérent des associations suivantes: _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ </span></li> </ul> <ul type="disc"> <li><span style='font-size:11.0pt;font-family:Arial;'>J'autorise, Je n’autorise pas la communication de mon nom, de mon adresse postale et électronique (courriel) à des fins d'échange avec d'autres adhérents généalogistes (1).</span></li> </ul> <p><span style='font-size:11.0pt;font-family:Arial;'>Fait à _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _le </span></p> <p align=right>Signature</p> <p align=right>(faire précéder la signature de la mention “lu et approuvé”)</p> <p>(1) barrer les mentions inutiles.</p> <p>(2) règlement à effectuer par chèque postal ou bancaire et à adresser à <i>Huguenots de France</i> au siège.</p> </td> </TR> </TABLE> </TD> </TR> </TABLE> <HR ALIGN="center" size=5 WIDTH="65%"> <BASEFONT size=3><A NAME="pgbot"></A> </basefont><CENTER><span style="font-size:8pt;">Publié par </span><A HREF="http://huguenots-france.org/association/association.htm"><span style="font-size:8pt;"><font color="blue">Huguenots de France</font></span></A><span style="font-size:8pt;">®</span></CENTER> </BODY>