Membership form

In order to become a member of the Société Internationale des Amis de Mohammed Dib, please fill in the form below. Your personal data will only be used for the membership and for the information purposes of the SIAMD.

We would like to point out that your membership will only be effective once we receive your membership fee that we kindly ask you to pay within two weeks of your online registration. The payment details will be sent to you in a return e-mail after your registration.

Questions concerning the membership of the SIAMD can be directed to administration[at]siamdib.com.

Fields marked with an asterisk (*) are mandatory.

Title*

Last name*

Given name*

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Type of membership*