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    Donations for EBM/MASA

    Project List 1/2005 (Pdf document available)    
    ==> show/download

    If you wish to support our work financially, you can give us a direct debit authorisation by using this page. As soon as you click on the box "Send", the content is sent to us by e-mail. If this procedure is not secure enough for you, you can fill in the page on the screen, then print it and send it to us by fax or letter. Thank you in advance for your support. You are helping us to help others.


    Direct debit authorisation

    I/we herewith grant you revocable authorisation to collect the following payments which are payable by me/us by direct debit:


    Name of the bank:

    Bank code:

    Account number:

    Account holder:

    Amount (EUR) :

    Designated use :

    Number of bookings:

    One single amount
    Monthly, on the of each month
    every months, on the of each month
    Annually, on the
     

    Personal data


    My/our mission friend's number is:

    Title:
    Name:
    Name, line 2:
    Street/post box:
    Post code/place:
    Country:
    E-mail: