ATKV Membership application form


Title

Initials

Full names

Surname

Gender

ID

Race group (for statistical purposes)

Particulars of dependants

Spouse (Full names)

Title

Gender

ID Number

Child 1 (Full names)

Gender

ID Number

Child 2 (Full names)

Gender

ID Number

Child 3 (Full names)

Gender

ID Number

Child 4 (Full names)

Gender

ID Number

Occupation

Home telephone

Work telephone

Cell phone

Email

Occupation Spouse

E-mail

From time to time it will be necessary for the ATKV and its strategic partners to contact you. You will always have an opt-out function.



Postal address

Postal address line 2

Postal address 3

Postal code

Frequency of payment

Information for credit card payments is available on request.




DECLARATION


1. We subscribe to the main objectives and values contained in the ATKV Constitution and that we strive to attain these
2. We comply with the membership requirements set out in the ATKV Acts
3. We subject ourselves to the ATKV Board’s.
4. The information provided is correct
5. We undertake to ensure punctual payment of membership fees as we agreed to pay
6. We respect the intrinsic Christian values of the ATKV and the ATKV’s mission to spread the Christian message

I accept/do not accept the declaration

I am younger / older than 18 years

I am younger than 18 years and I am assisted by my parents or legal guardian


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