CONSEIL INTERNATIONAL DU SPORT MILITAIRE INTERNATIONAL MILTARY SPORTS CISM REQUEST FOR A CISM STAR OF SPORTS MERIT
Summarizing file concerning:
Rank: ……………… Surname: ……………………….. Given Name: …………………………..
Discipline: ............................………
A.Enumeration of results obtained from 19…... to... PARTICIPATION INCITY OF THE # YEARCOUNTRY CHAMPIONSHIP INDIVIDUAL TEAM 1 2 3 4 5 6 7 8 9 B.Requested CISM Star of Sports Merit Bronze Star(2 x World Military Championship)medal+bar(46€)bar (8 ) Silver Star(4 x World Military Championship)medal + bar (46€)bar (8€) Gold Star(6 x World Military Championship)medal+bar(46€)bar (8 ) Double Gold Star Date (9 x World Military Championship)medal + bar (46€)bar (8€) :………………… Rank, name and Sign of the Chief of Delegation :………………………………………………………….. PS:CISM General Secretariat can only send the medals or/and bars after receiving the corresponding payment on the following Bank account : FORTISBANQUE – account number 210-0910136-37 (Swiftcode: GEBABEBB36A) IBANBE35 2100 9101 3637 Avenue Louise 200 – 1050 Brussels - Belgium