diff --git a/src/membership/templates/membership/membership_form.html b/src/membership/templates/membership/membership_form.html
new file mode 100644
index 0000000..b075c71
--- /dev/null
+++ b/src/membership/templates/membership/membership_form.html
@@ -0,0 +1,34 @@
+{% extends "base.html" %}
+{% load i18n %}
+
+{% block title %}{% trans "Edit Userprofile" %}{% endblock %}
+
+{% block teaser %}<h1>{% trans "Edit Userprofile" %}</h1>{% endblock %}
+
+{% block maincontent %}
+<form method="post" action="" enctype="multipart/form-data" class="grid_12 clearfix">
+<fieldset>
+<legend>{% trans "Edit Userprofile" %}</legend>
+{% csrf_token %}
+{% include  'form.html' %}
+<p class="buttonbar">
+ <button type="reset"><span class="fa fa-undo"></span> {% trans "Reset" %}</button>
+ <button type="submit"><span class="fa fa-hdd-o"></span> {% trans "Save" %}</button>
+</p>
+</fieldset>
+</form>
+{% endblock %}
+
+{% block javascript %}
+$(function() {
+    $( "#id_birthday" ).datepicker({
+      changeMonth: true,
+      changeYear: true,
+      dateFormat: 'yy-mm-dd',
+      yearRange: '-50,0',
+      firstDay: 1
+    });
+  });
+{% endblock %}
+
+{% block buttonbar %}{% endblock %}