Application Form

If you have trouble with the online application form, then please use the link below for a PDF version which you can print out at home and post to the address provided on Contact Us.

membership form 2017-18

Payment is not taken online, but should be forwarded separately to the bank details on the form or on Membership page.  We will match things up and as soon as your fee is received you will start receiving your monthly newsletter and  or username with a password for the BLC website with invites to your local area events.

If you have children please read and complete our Child Protection Policy form.

* indicates required field


Membership Type: *
Please choose one: *
If known, Membership Number:

I agree to have my details published, except for the first line of my address in the Newsletter and BLC Directory.
The BLC Directory is printed as well as sent digitally to members, as well as included in our password-protected members only of the BLC website.

NB first lines of addresses and phone numbers will not be published in the newsletter:

Published? Please tick: *

I agree to be part of the BLC E-mailing list for a monthly digital newsletter and updates on forthcoming events as well as membership
renewal reminder / information

E-Mailing? Please tick: *
Name: *
Address: *
Home Number:
-
Mobile:
-
E-mail: *
Nationality:
Facebook Alias:

Information which is helpful to the Club in organising appropriate activities and outings - please tick where appropriate


When did you arrive in Luxembourg? Month / Year:
Decade you were born:
Languages spoken:
Do you have children:

If yes, what ages?


0-4 years:
5-12 years:
13+ years:
Would you like to be included in the Children's Coordinator's email group?:
How did you hear about the BLC?: *
If other, please specify:
For events & activities, which do you prefer?: *
Which Groups would be of interest to you?:
If other, your suggestion
I have paid into the bank account below (use drop down menu): *

Bank: BCEE
Account Name: BLCL
BIC code: BCEELULL IBAN: LU06 0019 2855 9484 8000


Payment Ref: BLC Membership 2017/18 and please state your name if different from the account holder or membership number if known and membership type.


Monies to be received in EUROs only. Please do not send any cheques.


FOR THE PURPOSES OF ATTENDING OR HOSTING EVENTS IT IS ESSENTIAL FOR MEMBERS TO ENSURE THAT THEY 

HAVE FAMILY CIVIL LIABILITY INSURANCE (RESPONSABILITÉ CIVILE).


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