BG Membership: Online Registration Form   back  

To sign up for BG membership, please complete this form and click "Send Registration." Your application will be copied to your e-mail address.
(Note: If you do not enter a valid e-mail address, your application will not reach the BG.)

After you have been listed as a BG member, you will receive an initial copy of the BG newsletter. Attached you will find a payment slip for the  annual dues. Upon receipt of payment, your membership will be activated.

For a period of test you can activate your membership by purchasing a "Membership package for new members" at our BG-online store after submitting this form.

If there are any open questions: Please contact the BG office (Contactaddress).

First Name: required field!
Last Name: required field!
E-mail Address: required field!
(for example, james1701@aol.com)
Street Address Line 1: required field!
Street Address Line 2:
City / Town: required field!
State: * For US Residents Only
Postal / Zip Code: required field!
Country: required field!
Phone Number:    
Mobile Phone Number:    
Fax Number:    
Do you Speak German?   Yes, I do     No, I don't        A little
Are you a member of the 
Burgenland Bunch? 		  Yes, I am     No, I am not     Not yet
Comments:
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BG-Hometop of page  
 
August 5, 2006