Membership Form


TULLIANA.EU - S.I.A.C.
Membership

The information in this questionnaire are intended to file our Members Files.

Required field I enclose my membership using:
Check: Société Internationale des Amis de Cicéron, 9, avenue Sainte Foy, 92200, Neuilly-sur-Seine, France
RIB: RIB: 30002 00689 431482Z 51
IBAN : FR46 3000 2006 8900 0043 1482 Z51
Code BIC or SWIFT : CRLYFRPP
Crédit Lyonnais Paris Pyramides
20, avenue de l'Opéra
75001 Paris France
Paypal (Watch the site)
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Required field First name

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Required field Surname

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Your acronym

Your acronym is the signature of your bibliographic notes. It must be four characters long (for example: Theodor Mommsen: ThMo). Your acronym will be on the members table.

Date of birth

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Adress
City
Zip code
State (for United States) Members living in USA or federal countries
Required field Country

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Phone
Required field E-mail

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Insert a valid e-mail
Your Home page
How did you know Tulliana?:
Member
Tulliana.eu
Other site
Other

You are:
From University
Researcher
Private

Required field Do you wish to be scientific member?:
Yes
No

Your Username

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Your Password

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Confirm Password

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Retype the password correctly

Required field All form fields marked with asterisk must be completed

By submitting this form, you consent to the processing of your data by the S.I.A.C., under the Regulation UE 679/2016 and our Privacy Policy