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Print the form, sign it, enclose the fee, and mail it to the address at the bottom.  Membership is 60 DM per year.  (60DM = 32USD)

 Application for Membership

To the Executive Committee of the Association of the:
Künstlerinitiative East Side Gallery Registered Association

I, ______________________________________________________________
            (Please Print: First Name, Last Name)
________________________________________________________________
            (Address)
________________________________________________________________
            (City)                                                                                (State/Province)      
________________________________________________________________
            (Country)                                                                           (Postal Code)
________________________________________________________________
            (Telephone)                                                                        (Fax)
________________________________________________________________
            (E-mail,  myname@mycompany.com)
________________________________________________________________
            (Web Site,  http:www.mycompany.com)

support the purpose and vision of the Society of the Künstlerinitiative East Side Gallery Registered Society and would like to become a member.  I have enclosed a membership fee in the amount of (Deutsch Marks - DM) _______________ but at least DM 60,- per year. (60DM = 32USD, 9/11/99)

____________________________________________________________________
            (Location, Date)
____________________________________________________________________
            (Signature)

Enclose your check or money order, and mail it to: 
Künstlerinitiative East Side Gallery e.V.
c/o Katharina Kräling
Nehringstr. 5
14059 Berlin, Germany