fib - federation international du beton

	Postal Address	Street Address (map)	Phone / Fax	Contact
	Case Postale 88 CH-1015 Lausanne	Office GC A2 424 at the Swiss Federal Institute of Technology Lausanne (EPFL)	phone +41 21 693 2747 fax +41 21 693 6245

Membership Application

To become a member of fib, simply fill out the form below, print it (if you are unable to print this page, please download the PDF version), and fax it to:

fib
Case Postale 88, 1015 Lausanne (Switzerland)
Fax + 41 21 693 6245

The + sign stands for the International Direct Dialing prefix in your country (e.g. 011 in North America, 00 in European countries).

Starting with the current year, I / my company want(s) to join fib as:

Ordinary Member [180 CHF/year] Student Member [80 CHF/year]

Subscribing Member [440 CHF/year] Associate Member [825 CHF/year]

Supporting Member [1250 CHF/year] Sponsoring Member [2500 CHF/year]

(CHF = Swiss Francs)

Exact mailing address:

Title

First Name

Family Name

Date of birth (year-month-day)

Name of firm
(if applicable)

Street

Post code, City

Country

Phone, Fax

E-mail

Payment by:

Credit card: MasterCard Visa card

No: Exp. date:

Cardholder's name (as printed on card):

remittance, free of charge for the receiver, to:
fib - fédération internationale du béton, 1015 Lausanne, Switzerland, account Nº 710.250.00 V
at the Union Bank of Switzerland (UBS), Case Postale 2950, CH-1211 Geneva 2, Dépôt
(Swiftcode: UBSWCHZH12A, IBAN: CH19 0024 0240 7102 5000 V, BIC: UBSWCHZH80A)

How did you learn about fib?

Through an fib publication	Event - please specify:
Internet search	Other - please specify:

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