membership form

ODASCE—Association Loi 1901—24, rue Chauchat 75009 PARIS – Tél. : + 33 (0) 1 55 34 76 80 – Fax : + 33 (0)1 55 34 38 20
Siret : 7842 05148 00066 – N° TVA : FR57784205148 – www.odasce.asso.fr – [e-mail]
Full legal name:
Business field :
Adress :
Phone number : Fax number :
EU VAT number :
 Integral Formula : Group or Multi-Sites Company Membership - 3 055.00 € per year, exc VAT
 Integral Formula : Single-Site Company Membership - 1 978 00 euros per year, exc VAT
 Integral Formula : Personal membership - 999.00 EUROS per year exc. VAT
 Individual membership - 134.00 euros per year inc. VAT (108.70 per year exc. VAT)
 Retired membership - 71.00 euros per year inc. VAT
DESIGNATED CONTACT PERSON (who will represent the company at the General Assemblee of members)
If you do not wish to appear as a member in our documentation and on our website, please check this box 
CHOSEN FORM OF MEMBERSHIP
COMPANY
BILLING ADDRESS (if different)
Full legal name :
Adress :
Contact : Phone :
Last name : First name :
Job title :
Phone number : E-mail :
Extra contacts for the flashes’ mailing list (First and last name, e-mail) DATE, COMPANY SEAL AND SIGNATURE
Upon receipt of the application form a membership number will be assigned and sent with the invoice.
Payment only by bank transfer or check.
Membership begins the month of your registration and will be valid for one year from that month.
A renewal invoice will be sent 1 month before the anniversary date of membership, any decision not to renew should be notified by mail
or e-mail no later than the anniversary date.
More details (for example order n° , mandato-
ry, process...) :
Not modifiable except for valid reasons and with a notification by mail or email
PLEASE SEND BY MAIL OR E-MAIL TO CATHERINE AMANDIO
ODASCE  : + 33 (0) 1 55 34 76 80
24, rue Chauchat  : + 33 (0) 1 55 34 38 20
FR-75009 Paris (France) @ : contac[email protected]g
MEMBERSHIP FORM 2015

ODASCE—Association Loi 1901—24, rue Chauchat 75009 PARIS – Tél. : + 33 (0) 1 55 34 76 80 – Fax : + 33 (0)1 55 34 38 20
Siret : 7842 05148 00066 – N° TVA : FR57784205148 – www.odasce.asso.fr – [email protected]
MEMBERSHIP FORM 2015