Application Form

Couple membership (274)

Couple membership

We would like to apply for couple membership.

Details person 1:

Title:

First name:*

Surname:*

Year of birth:*

Details person 2:

Title:

First name:*

Surname:*

Year of birth:*

Address:

Institution / company:

Street / No.:*

Postal code / town/city:*

Country:*

Telephone:*

Fax:

E-Mail:*

Edition of Annual Review:*

Paperback

Hardback (surcharge CHF 20.- p/a)

Language of correspondence:*

German

French

Message:

Field « Security code » - please enter the result of the calculation.

Security code:

captcha

Don't fill this field!

SWISS ARCHAEOLOGY

Archaeologie Schweiz
Petersgraben 51
CH-4051 Basel
Tel +41(0)61 261 30 78
Fax +41(0)61 261 30 76
info(at)archaeologie-schweiz.ch
Mon to Thu 9am-12pm / 2pm-5pm