Charity
Sign in to Google to save your progress. Learn more
Email *
Name + Surname *
I would like to donate money to the Charicie. This money will be donated to Stichting Het Overweeghuis once all the donations are collected. *
I would like to donate... *
Bank account number (IBAN) *
Initials + last name of the bank account holder *
I allow Study Association Esperia to withdraw the donation (€2,50 or €5,-) from my bank account. *
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of University of Groningen. Report Abuse