Name, Surname:
E-mail:
Place, Day, Month of Birth:
Postal Address:
Nationality:
Job/Hobbies:
Contacts (address, telephone, e-mail):
Why you join the organization:
I have read the Charter of the Organization. I support the organization’s goals. I am obliged to meet the organization’s requirements for “Ordinary” members of the Common House of Caucasus. I am obliged to pay annual membership fee of 50 zloty/USD 22 to the organization’s bank account. I wish to be a member of the Common House of Caucasus in Poland