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					  Application Form                              International Pen Friends – www.ipfeurope.com                                                 Form 00A 101E-A/03/07

                 Please Write Clearly
  Surname
                                                                                                                   Date of Birth
  First Name                                                                                                                             (Day/Month/Year)
                                                                                                                   Age this Year
  Street Address
                                                                                                                   Male or Female            Male            Female
                                                                                                                   Marital Status           Married         Single
  Suburb/Town                                                                                                                               Other:

  State                                                                                                            Religion
                                                                                                                   Occupation
  Post Code
                                                                                                                              For Office Use Only:
  Country

  E-Mail :                                                                                                                                                    8409
 *Please sign to confirm that the information you have provided is correct*
 If you are under 18 years of age, please have a parent or guardian sign on your behalf.
 If you are joining our C2, C4, C6 or C8 service, please write the name of the person you are joining with:

Do you require male or female correspondents or both?                  Male          Female           Both
In what languages do you wish to correspond?                English       French      German       Greek       Italian     Portuguese      Russian      Spanish
 What is your main interest or hobby?
 Have you ever been a member of our club?                                      Yes         No
                                                                           Membership Number, if known:

 How or where did you learn about our Club?
Tick whichever items are of general interest to you:
   Animals          Camping            Cooking             Exchange holidays       Gardening             Internet        Music              Reading               Sport
   Antiques         Cars               Crafts              Farming                 Genealogy             Languages       Philately          Religion              Theatre
   Art              Chess              Dancing             Fashion                 Health & Fitness      Literature      Philosophy         Science               Travel
   Astrology        Computer           Environment         Fishing                 History               Movies          Photography        Social Work           Writing
Tick any items you would be interested in exchanging :            Cards        Stamps          Souvenirs        Dolls       Books         CDs
Please tick AT LEAST 8 DIFFERENT COUNTRIES in which you would like to have pen friends. We always try to match country request,
but if there are request we cannot meet, we will provide you with pen friends from other countries .
Africa:
   Algeria    Angola        Kenya       Uganda       Egypt       South Africa      Africa General      Indian Ocean Islands General
The Americas:
   Argentina     Brazil      Canada       Caribbean      Columbia         Mexico       Peru      USA       South/Central America General
Asia/Pacific:
   Australia      Indonesia           Korea             New Zealand                 China            Taiwan            Asia-General
   India          Japan               Malaysia          Philippines                 Singapore        Thailand          Pacific Islands General
Western Europe:
   Austria     Denmark        Finland        Greece      Iceland       Italy      Norway       Spain        Switzerland Scotland        Western Europe General
   Belgium     France         Germany        Holland     Ireland       Malta      Portugal     Sweden       England       Wales
Eastern Europe:
   Albania     Croatia                  Estonia         Latvia            Poland          CIS                  Slovakia         Eastern Europe General
   Bulgaria    Czech Republic           Hungary         Lithuania         Romania         Russia               Ukraine
Middle East:
   Israel      Saudi Arabia             Iran            Turkey            Middle East General
Tick Services Required               Service Fees                                 US$          EURO€                   UK£          AUD $              YEN
    C1 Service: For one person aged 8-14 (a list of 10 pen pals) .......... ......$ 25. ..........€16....................£12............$28..............¥2,000
    C2 Service: For two persons aged 8-14 (two lists of 7 pen pals) ..... ......$ 35. ..........€22....................£16............$38..............¥3,000
    C3 Service: For one person aged 15-20 (a list of 14 pen pals) ........ ......$ 30. ..........€20....................£14............$32..............¥3,000
    C4 Service: For two persons aged 15-20 (Two lists of 7 pen pals) .. ......$ 40. ..........€25....................£18............$42..............¥4,000
    C5 Service: For one person aged 21-60 (a list of 14 pen pals) ........ ......$ 35. ..........€24....................£17............$38..............¥4,000
    C6 Service: For two persons aged 21-60 (Two lists of 7 pen pals) .. ......$ 45. ..........€30....................£22............$48..............¥5,000
    C7 Service: For one person aged over 60 years (a list of 14 pen pals) ......$ 30. ..........€20....................£14............$32..............¥3,000
    M1 Service: Subscription for 4 issues of Club Magazine .............. ......$ 35. ..........€25....................£15............$35..............¥4,000
    M2 Service: Subscription for one issue of Club Magazine ............ ......$ 12. ..........€10.....................£5.............$12..............¥1,500
    Please tick if you would like to be sent details on our service for school classes and youth groups (minimum 10 students)

Please return this form with your Service Fee (or the receipt of your payment) to :
International Pen Friends, 4 Rue Lieutaud, 13100 Aix en Provence, FRANCE

The admission fee should be paid by: Cash Notes (not coins) or Personal Cheque or Bank Draft or International Postal Money Order
(we cannot accept local US postal money orders), made payable to: International Pen Friends. On the Internet using PayPal
(www.paypal.com) to our account ipf@ipfeurope.com. Only if you pay by cheque/bank draft, please add 2€, 2$, 2£, 200¥ to the total
fee amount. By bank transfer to Banca Poste Italiane Spa, IBAN: IT48 W076 0103 4000 0009 7174 361 BIC/SWIFT: BPPIITRRXXX
Account name: Andrea D’Ambra. By Western Union, in this case the payment has to be made to the order of Andrea D'Ambra.

				
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Description: Application-forms