New subscription

This form allows you to record your subscription as a new member of the foundation. If you want to renew your subscription (if already a member), please contact foundation board instead by email sushy@debian-facile.org.

Fields with * are mandatory

Nature of the member *
Last name *
First name *
Company
Address
Zip Code / City	/
Country
State/Province
Email *
Date of birth
URL of photo/logo
Information is public
Mode de paiement *
Comments
Subscription	Euros