Please complete the Online Membership Application Form below and press the "SEND" button.

MABL ONLINE MEMBERSHIP APPLICATION

Applicant - Information
Name: MaleFemale
Address:
Telephone: Mobile:
Email: Nationality:
Occupation:
Interests:

Spouse/Partner - Information
Name:
Telephone: Mobile:
Email: Nationality:
Occupation:
Interests:

Children - Information
Name Date of Birth M/F

MEMBERSHIP INFORMATION
MABL 2011 Annual Subscription Rates
  • Student: €18
  • Individual: €28
  • Family: €38
Membership Subscription Type:

Total Amount:€
Payment by:

If paying by Bank Transfer, please write
“ MEMBERSHIP – THE YEAR – YOUR NAME ”

MABL Account Nr: 330-0652807-51
IBAN: BE75-3300-6528-0751
Allow personal data to be published on Members Directory          Yes: No:


Enter verification code (No spaces, NOT case sensitive)


Back to top