I want to become a member

The Jacob Pins Society, founded in 2002, already has more than 200 members. These are citizens of Höxter as well as people from other parts of Germany and abroad.

Please support us by becoming a member!

Membership Application Form

Last Name: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

First Name: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Street and Number: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

ZIP Code/City: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

E-Mail: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Hereby I declare my admission to the Jacob Pins Society.

The annual subscription fee is at least 40,- Euro or 25,- Euro for students. Your membership includes free admission to the Forum Jacob Pins.

I agree that the fee may be withdrawn from my bank account.

Bank Account:

Name of the Bank: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Account Number.: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Bank Code: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Amount of my annual fee/my donation: _ _ _ _ _ _ _ _ _ _ _ _ _

City and Date: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Signature

Please print and send to:

Jacob Pins Gesellschaft
Westerbachstraße 35-37
37671 Höxter
Germany

phone +49(0)5271-6947441
jacob-pins@jacob-pins.de

Our Bank Accounts:
Volksbank Paderborn-Höxter-Detmold, Bank Code 47260121, Account Number 2051217700, IBAN DE22 4726 0121 2051 2177 00, BIC DGPBDE3MXXX