Forma Endametiyê                                                                             

Dem,Mêjû: .................

Bi vê nameya xwe, ez daxwaz dikim, ku 

di NAVENDA P.E.N. A KURD  de bibime endam.  

Pêşnav: ........................................................................................
 
Paşnav: ........................................................................................

E-Mail : .........................................................................................

Tel.     : .........................................................................................

Berhemên çapkirî:

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Endamên ku min pêşniyar dikin:

1. …………………………………….............

2. .............................................................

Ezê endametiya xwe ya salekê bi kêmayî 60 €  bidim. Navnîşana Konto:
Kurdisches PEN-Zentrum, Navenda PENa Kurd e. V.; Dresdner Bank, Konto-Nr. 4 757 403 00, Blz.: 700 800 00

Destnîşan:

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