On the 10th of March 2012
	we celebrate the 65th anniversary of the
	"Koninklijk Gallois Genootschap"
	Where: Het 's Graevenhof
Turnhoutsebaan 439-445
B-2970 Schilde
Start: 19h00 Finish - 02h00
Dress code: business casual
Registration is necessary before February 29th. 2012

Name*		First name
Street*		N°
City*		Postcode
E-mail*
N° participant	x 65 €  for member & partner	Total	€
Payments will be done on the account of the Koninklijk Gallois Genootschap  IBAN BE36 9799 8300 5681 SWIFT : ARSPBE22   before February 29th of 2012