Membership Application Form

Annual membership fees for collective and individual members

The annual membership fees for collective and invidivual members are determined in relation to the gross national income per capita, according to the classification published by the World Bank.

Membership fees for 2010:

For the following countries (category of "high income")
Andorra, Australia*, Austria*, Belgium*, Canada*, Canada-Québec*, Denmark, Finland, France*, Germany*, Greece, Iceland, Ireland, Israel, Italy*, Japan*, Korea Rep., Kuwait, Luxembourg, the Netherlands, New Zealand*, Norway, Portugal*, Saudi Arabia, Singapore, Slovenia*, Spain*, Sweden, Switzerland*, the United Kingdom* and USA:

Collective members: 455 €
Individual members: 56 €

For other countries:

Collective members: 280 €
Individual members: 28 €

(For countries with an asterisk, please contact the PIARC National Committee of the country).

Personal Information

LAST NAME / First NameOrganisationAddress (number / street)Zip Code / CityCountryPhoneFaxE-mailPreferred Language

Method of Payment

By enclosed check in Euro on a bank domiciliated in France, made out to PIARC By bank transfer in Euro to PIARC account N° 6629S, Key 27, Agence 775 Crédit Lyonnais - 90, Av. Gén. de Gaulle, 92400 COURBEVOIE(France) - International bank references: IBAN: FR72 3000 2007 7500 0000 6629 S27 / BIC: CRLYFRPP By credit card (VISA international or MASTERCARD only)

I agree to have the following amount (€)charged to my credit card account:This credit card is valid until:Credit card verification number (*)Date:

(*) The credit card verification number is a three-digit number printed on the back of your card.

Please sign this form and send it back to:

Association mondiale de la Route (AIPCR) / World Road Association (PIARC)
La Grande Arche - Paroi Nord, Niveau 5
92055 LA DEFENSE Cedex
FRANCE
Fax +33 1 49 00 02 02