Application: ID Card

The issue of an ID-card of the LAZARUS UNION is requested:

ALL fields are required!



First name(s):

Date of Birth:

Place of Birth:

Number of the membership decree:

Date of issue:

Current rank:

Current function:

Issue fee paid: YesNo

A picture in JPG format (Minimum 300 x 400 Pixel, maximal 1 MB) has to be attached, otherwise this application can't be processed and the mail can't be sent!