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Membership contract for private persons

The repeat customer registration fee is 20 euros ,which contains a presentation folder. The Repeat customer registration fee does not contain delivery fee(you can choose the way of delivery and the price on the bottom of the page).

Data of the applicant
Surname: *
Forename: *
Address:
country: *
county: *
Zip code: *
city: *
street, street number: *
sex: *
Date of birth (dd-mm-yyyy): *	- -
Telephone number: *
E-mail address: *

Optional data

Membership fee:

It is 20 euros , which contains a presentation folder..

Declaration:

I agree the following: *

	I declare, that the above given data is true. I acknowledge If any false data is recorded into the system, DXN reserves the right to delete my registration without any previous notification.
	I declare that i and my spouse have not been active in DXN in the past 12 month and that non of us has joined DXN before.
	I accept that i become a repeat customer officially after confirming this membership application form.
	I have read and agreed with DXN rules.

Skype ID:

Spouse data ( if married):
Name:
Mother's maiden name:
Identity card number:
Passport number:
sex:
Date of birth (dd-mm-yyyy):	- -
Have your spouse registered before?
Previous codenumber:

Heir data( if it is not filled, the heritage will be according to laws):
Name:
Mother's maiden name:
Identity card number:
Passport number:
sex:
Date of birth (dd-mm-yyyy):	- -
Relatives:

Membership contract for private persons

Data of the applicant

Address:

Spouse data ( if married):

Heir data( if it is not filled, the heritage will be according to laws):

Declaration: