MEMBERSHIP REGISTRATION FORM

MEMBERSHIP FORM

Mr.Mrs.Miss

First Name *

Last Name *

Nationality *

Date Of Birth *

Phone Number *

Email *

Profession *

MEMBERSHIP CATEGORY *Person under 18 yrs and Student - 10,000 TshPerson above 18 yrs - 30,000 TshFamily over 3 persons - 70,000 Tsh

How would you like to pay? *Pay at Alliance Francaise CampusPay Online

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