Membership REGISTRATION FORM According to Article 8 of the Fundamental Bylaws of the Romaïan Cultural Society, each eligible person who wishes to adhere to the Society should express his wish accompanied by a photocopy of his ID and a judiciary record. PERSONAL INFORMATION PLEASE ENTER CORRECT AND PRECISE INFORMATION Name 2nd Nationality (If Available) Father's Name Family Status Family StatusSingleMarriedWidowDivorced Family Name Spouse Name & Family Mother's Name Spouse Birth Year Spouse Birth Year20122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915191419131912191119101909190819071906190519041903190219011900 Religious Denomination Address (Bldg., Sector, City, Country, ZIP Code) Civil Registry Number Home Phone Number Civil Registry Place Mobile Number Date of Birth (D/M/Y) * Email Address Place of Birth Other Communication Possibilities Profession Spoken Languages Basic Nationality Education Level Education LevelPrimary LevelSecondary LevelBachelor or MastersDoctorate BEFORE PRESENTING THE APPLICATION FORM TO THE ADMINISTRATIVE COMMITTEE, IT IS PREFERABLE TO JOIN THE NAMES OF TWO MEMBERS OF THE RCS WHO WISH TO ADOPT THE APPLICATION Name 1 Name 2 TO FACILITATE THE ADMINISTRATIVE PROCEDURES, IT IS PREFERED THAT THE FIRST ANNUAL FEE (US$70) IS ADVANCED, by Western Union. I read... I READ AND AGREE ON THE CONDITIONS OF ADHERING TO THE ROMAIAN CULTURAL SOCIETY DATE : SUBMIT