FRIEND OF THE ASSOCIATION APPLICATION FORM I, the undersigned, declare to become a Friend of the Association of the European Pharmaceutical Students’ Association (EPSA) and will pay the fee of:  40 € for one year  __ € for one year (more!) As a Friend of Association I shall: • Receive a copy of each edition of the EPSA Newsletter at the address given at the moment of registration; • Be added in EPSA News e-group; • Receive information about EPSA activities and official calls; • Receive the minutes from the General Assembly; • Have the right to participate in all EPSA projects and events; • Have the right to be present at the General Assemblies; Name Address (used for sending the publications)

City E-mail MSN University

Country Mobile Skype Year of studies

Signature:

Date:      

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The money should be transferred to the following account:

Our Bank information: Account Number: 001-6372217-72 Account Beneficiary: E.P.S.A. Bank: BNP Paribas Fortis, Montagne du Parc 3, 1000 Brussels, Belgium BIC/SWIFT: GEBABEBBXXX IBAN: BE38 0016 3722 1772