New Electrical Fire Victims Association - Association Des Victimes des Incendies d'origine Electrique

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Electrical fires victims association join

Request for membership to the Association

Print this application form and returned by the post office to the address as follows:

Eletcrical Fire Victimes Association
P.O. BOX 295
North Springfield, VT 05150

New ADVIDE-EFVA thanks you for your request.

I (Full Name, and for companies name and address, and name and address of legal representative)




City, State, Zip Code and Country __________________________________________________________________________________

request to join the "New ADVIDE-EFVA". I acknowledge having read the legal statutes and rules of procedure, and fully accept the content.
I give my valid e-mail address: _____________________________________

I wish to submit my application for membership to the New ADVIDE-EFVA. I read the Bylaws and the Rules & Regulations of the association and I fully accept the terms. Once my application will be approved by the board of the association, I agree to pay the annual fee.

r I declare to act for the above company r I declare to act for myself personally and I certify that I do not act directly or indirectly on behalf of any company with my membership

Signed at (city) _________________________, the (date) ______________________

Signature _________________________

In case of lost mail, please complete the online form below:

The New ADVIDE-EFVA thanks you for your request and hopes to count you among its members.


The information gathered is needed for your membership. It is subject to processing and is destined for the secretary of the association New ADVIDE-EFVA" . According to Resolution No. 2006-138 of 09 June 2006 of the French law, deciding for the waiver statement, the association New ADVIDE-EFVA is exempt from CNIL registration.Under French Law, Article 34 of the Act of 6 January 1978, you have the right to access and rectify information concerning you. If you wish to exercise this right and receive information about yourself, please contact the secretary of the association:

All documents posted on this site are protected by copyright. Any use or distribution, even partial, is strictly prohibited without the expressed written permission of the New ADVIDE-EFVA.

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