"; if (!eregi("^[_\.0-9a-z-]+@([0-9a-z][0-9a-z-]+\.)+[a-z]{2,5}$", $email)) $warning .= "Incorrect e-mail address !
"; if(!isset($warning)){ $subject="Nouveau membre CETIM"; $body .= "> Demande en anglais

"; $body .= ""; if ($member==1) $body .= "je souhaite devenir membre individuel
"; elseif ($member==2) $body .= "je souhaite devenir membre de soutien
"; elseif ($member==3) $body .= "nous souhaitons devenir membre collectif
"; elseif ($member==4) $body .= "nous souhaitons devenir membre collectif de soutien
"; elseif ($member==5) $body .= "je désire devenir un sympathisant du CETIM
"; $body .= "
"; $body .="Nom: ".$name."
"; $body .="Année de naissance: ".$year."
"; $body .="Organisation: ".$org."
"; $body .="Adresse: ".$address."
"; $body .="NPA / Ville: ".$city."
"; $body .="Pays: ".$country."
"; $body .="Téléphone: ".$phone."
"; $body .="Email: ".$email."

"; $body .="Remarques:
".stripslashes(str_replace(chr(13),"
",$remarques))."

"; mail($email_default,$subject,$body,"From: contact@cetim.ch\r\n"."MIME-Version: 1.0\r\n"."Content-type: text/html; charset=iso-8859-1\r\n","-r contact@cetim.ch"); $status = "ok"; } } ?> CETIM - Centre Europe - Tiers Monde
Becoming a member of the CETIM

Your request has been sent

Close


";?>
> I wish to become an individual member (50 CHF / 30 EUR, 10 EUR South)
> I wish to become a supporting member (100 CHF / 60 EUR)
> We wish to become a collective member (200 CHF / 120 EUR)
> We wish to become a collective supporting member (500 CHF / 300 EUR)
> I wish to become a sympathiser of the CETIM (15 CHF / 10 EUR)
(no free book or discount on the books ordered at the CETIM)

Name & firstname *
Year of birth
Organization
Address *
Postcode & Town *
Country *
Phone *
Email *
Remarks
(*) obligatory fields