ENROLLMENT FOR INDIVIDUAL MEMBER

First and last name ............................................................................................

Date of birth ........................................................................................................

Profession/Speciality ..........................................................................................

Scientific title ................................................ Function ......................................

Office name and address (exactly) ....................................................................

............................................................................................................................

Departament ............................................................................................Phone

........................ Fax …................................. E-mail ...........................................

Personal address ...............................................................................................

Privat phone ………………….. Fax ............................. E-mail ...........................

Application form

The undersigned ...............................................................................................................

I ask my enrolment as an active member in the Romanian Welding Society. I oblige myself

to respect the statute of the Association.

Signature ..................................... Date ............................……………..