ILGA 81 Kolenmarkt B 1000 Brussels Belgium Phone / Fax: +32 2 502 2471 E-Mail: ilga@ilga.org

ILGA MANIFESTO ON HUMAN RIGHTS SUBSCRIPTION
Subscription Form for Organizations and Individuals.

If an organization, name of the organization:

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Name of the member of the organization
or of the individual who signs the subscription:

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Address of the organization or individual:

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City:

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Country:

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Telephone:

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Fax:

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E-Mail:

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Date:

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Signature: