Personal Membership Form

Personal Membership Form

We welcome you as the Official Membership of the World Mime Organisation
Your Name (as written in your Passport)*

PrefixFirst NameMiddle NameLast NameArtistic Name
Date of birth*

MonthDayYear
Country of birth
Citizenship
Address (Home/Postal)*

Street Address

Street Address Line 2

CityCountry

Postal / Zip Code
Email*
example@example.com
Mobile Phone Number

Country codePhone Number
Home Phone Number

Country codePhone Number
Choose your relation to mime*
Upload your CV / Resume

Browse Files

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Your website:
Your Facebook Page:
Your Youtube Channel:
Your Instagram account:
Your Twitter account:
Your other social network account or website:
You are now about to pay your Annual Membership Fee via PAYPAL:*
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Annual Membership Fee$20.00
You can pay for 3 years in advance which will guaranty the amount and make you eligible for an email address @worldmime.org

Quantity
Item subtotal:$0.00

Total $0.00
Terms and conditions: "By submitting this form with payment through PayPal I accept transferring funds to the World Mime Organisation as the payment of the Annual Membership Fee for the Personal Official Membership status." Membership fee covers the calendar year from January 1st to December 31st of the current year regardless when you have payed it. Bank transfer is an option if you do not have PayPal account. Contact us via email for bank instructions to office@worldmime.org*

MARK TO ACCEPT TERMS AND CONDITIONS
I am Human (type exact text from the picture)*
Secure online payment with PayPal

You will be transferd to PayPal payment secure page when you submit the form.

PLEASE CLICK SUBMIT
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