Change of address

Old details

Member no. *:
Salutation *: Dhr.Mevr.
Name *:
Address *:
Postal code *:
City *:
Country :

Telephone *:
Email* :

New details

Address *:
Postal code *:
City *:
Country :
Telephone *:

* required

**The memberships number is located on the address label of the verenigingsblad. This number is not required.

Remarks