Liberté pour le Tibet

Je, soussigné, .......... ...............

(prénom) (nom)

Maire de ...........................

province de .....................

...............

(Pays)

adhéré à la campagne internationale

pour la liberté du Tibet

et je m'engage également à hisser

le drapeau national tibétain

sur l'Hotel de ville

le 10 mars 1995

anniversaire du soulèvement de Lhassa de 1959

et verse à cette fin la somme de .... francs

sur le compte numéro .............

au nom de Parti Radical

transnational et transparti

..................

(Signature)

et demande que le drapeau soit envoyé

à l'adresse suivante: ......................................

.......................................

Parti Radical transnational et transparti, Parlement européen, REM 5.08, Rue Belliard 97, 1047 Bruxelles. Tel. 32-2-284.25.79, fax. 32-2-230.36.70.

___________________________________________________________

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