Pristupnica / Beitrittserklärung

Ime i prezime / Vor-und Zuname: ............................................................................................................

………………............................................................................................................................................

Ulica i broj / Straße, Haus-Nr....................................................................................................................

………………............................................................................................................................................

Mjesto stanovanja / Wohnort ...................................................................................................................

Dan i mjesto rođenja / Geburtsdatum, Ort: ………….............................................................................

………………............................................................................................................................................

Zanimanje / Beruf: …………...................................................................................................................

Telefon, Mobilfunk, E-Mail: ……….......................................................................................................

………………............................................................................................................................................

Želim postati član Hrvatske kulturne zajednice Wiesbaden.

Ich möchte Mitglied der Kroatischen Kulturgemeinschaft werden.

.......................................................................           ..................................................................

Mjesto i dan / Ort und Datum                                     Potpis / Unterschrift