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["X",null,"MEMBERSHIP APPLICATION FORM"]
[]
[]
[null,null,"Type of membership:"]
[]
[null,null,"Individual",{"$nulls":6}," ",{"$nulls":6},"Annual member fee CNY",{"$nulls":8},150]
[null,null,"Couple/ Family",{"$nulls":6}," ",{"$nulls":6},"Annual member fee CNY",{"$nulls":8},250]
[null,null,"Student",{"$nulls":6}," ",{"$nulls":6},"Annual member fee CNY",{"$nulls":8},0]
[]
[]
[null,null,"Personal data:"]
[]
[null,null,"Family Name",{"$nulls":13},"Date of birth (dd.mm.yyyy)"]
[null,null,"First Name",{"$nulls":13},"Nationality"]
[]
[null,null,"Spouse:"]
[null,null,"Family Name",{"$nulls":13},"Date of birth (dd.mm.yyyy)"]
[null,null,"First Name",{"$nulls":13},"Nationality"]
[]
[null,null,"Children:"]
[null,null,"Name",{"$nulls":13},"Date of birth (dd.mm.yyyy)"]
[null,null,"Name",{"$nulls":13},"Date of birth (dd.mm.yyyy)"]
[null,null,"Name",{"$nulls":13},"Date of birth (dd.mm.yyyy)"]
[null,null,"Name",{"$nulls":13},"Date of birth (dd.mm.yyyy)"]
[]
[]
[null,null,"Please indicate which e-mail address should be used to contact you:",{"$nulls":13},"Private",{"$nulls":8},"Business"]
[]
[null,null,"Addresses:"]
[]
[null,null,"Home address",{"$nulls":13},"Company address"]
[null,null,"Road",{"$nulls":13},"Road"]
[null,null,"Compound",{"$nulls":13},"Compound"]
[null,null,"Zip Code",{"$nulls":13},"Zip Code"]
[null,null,"City",{"$nulls":13},"City"]
[null,null,"Telephone",{"$nulls":13},"Telephone"]
[null,null,"Email",{"$nulls":13},"Email"]
[]
[]
[]
[null,null,"Mother tongue:"]
[]
[null,null,"Mother tongue",{"$nulls":4},"German ",null,null,"French",null,null,"Italian",null,null,"Romansh",null,null,"English",null,null,"Chinese",null," ","Other* (please indicate below)"]
[]
[null,null,"*Other language"]
[]
[null,null,"Mother tongue (spouse)",{"$nulls":4},"German ",null,null,"French",null,null,"Italian",null,null,"Romansh",null,null,"English",null,null,"Chinese",null," ","Other* (please indicate below)"]
[]
[null,null,"*Other language"]
[]
[]
[null,null,"Application form to be forwarded to:"]
[]
[]
[null,null,"Secretary Swiss Club Shanghai",{"$nulls":13},"Email",{"$nulls":5},"events@swissclubshanghai.org"]
[]
[null,null,"Application date (dd.mm.yyyy)"]
[]
[null,null,"Members who do not return this form and whose membership fee has not been settled for the last two years, will be taken out of the data base and are no longer be considered as a member."]
[null,null,"As long as there is no written notification to the Swiss Club that you whish to leave the club your annual membership fee has to be paid."]
[]
[]
[null,null,"Yearly membership fee payment"]
[]
[null,null,"The membership fee shall be paid to the Treasurer of the Swiss Club, Marco Cabalzar directly by payment to our bank account and/or at events.\n\nPlease ensure that your payment form shows following details:\nYour full name\n\nBeneficiary: CABALZAR MARCODURI\nA/C: 6214830215035063\nBank: CHINA MERCHANTS BANK, SHANGHAI TIANYAOQIAO BRANCH\n招商银行\n上海分行天钥桥支行\n\n\nWechat: Please add  ”derbuendner” as a wechat  contact to settle the membership fee.\n"]
{"$rows_empty":19}
[null,null,"Committee use only :"]
[]
[null,null,"Date (dd.mm.yyyy)"]
[]
[]
[]
[null,null,"Tick"]
[null,null,"x"]
[null,null," "]