In International Bankers Forum (IBF) Luxembourg Application for membership Name ............................................ First name ............................................ Date of birth …........................................ Nationality ............................................ Address ................................................................................................................. ................................................................................................................. Phone private …........................................ E-Mail private …........................................ My private contact data may be published Please do not publish my private contact data (to be used only for IBF member handling) _____________________________________________________________________________ Employer Company ................................................................................................................ Position ............................................ Department ........................................... Business address ................................................................................................................ ................................................................................................................ Phone …........................................ Mobile Fax …........................................ E-Mail ................................................................................................................ ........................................... _____________________________________________________________________________ I would like to apply for an ordinary membership (100 € p.a.) Date …........................................ Signature ........................................... ========================================================================= I will pay the annual membership of 100,- € to the account of IBF Luxembourg: Account no: BIC code: Account holder: IBAN LU18 0019 1000 0606 0000 BCEE LULL International Bankers Forum Luxembourg à.s.b.l. INTERNATIONAL BANKERS FORUM LUXEMBOURG asbl Adresse postale: 33, A Millesch L-6919 Roodt Syre Emai: [email protected] www.ibf.lu Compte: BCEE IBAN LU 18 0019 1000 0606 0000 Board members: Jörg Agostini, President (UBS Luxembourg), Reinolf Dibus, Ronald Kusch (von der Heydt Invest S.A.), Tobias Doerholf (E&Y), Frank Roessig (Akeance Consulting), Dr. Marcus Stutz (Deutsche Bank Luxembourg S.A.), Ralf Strauss (Syngeon S.A.), Herbert Weynand, (Wagner Group Luxembourg)
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