Arnulf Rainer Museum

Friends of the Museum

Membership Application

Membership *		Standard membership Additional family member Seniors Students (up to age 27) Date of birth Supporting member

First Name:*
Last Name: *
Address:*
City:*
Postal code:*
Country:*
Tel.:*
Fax:
E-mail address:*
My membership is good for a full calendar year (January to December) and will be automatically renewed for a year upon payment of the membership dues.
Bank transfer
Account number
Routing number
Bank
I hereby authorize you to charge my account in the following amount. I have the right to request a back transfer of the full amount, without explanation, within 14 calendar days of the original charge to my account.
Payment with transfer slip


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