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Vitalis Donorship Agreement
Great to welcome you as a donor of Vitalis. Your chosen package offers various ways to stay involved with the association. With your support we make Vitalis fit again!
The withdrawal shall take place annually on the 31st of December to the bank account number NL36 INGB 0007 6106 71 under the name G.S.A.V. Vitalis. After having completed the form, you shall receive a copy of the donorship agreement.
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Email
*
Your email
Name
*
Fill in your name as it is known at Vitalis.
Your answer
Donors package choice
*
An overview of the donorpackages can be found at the bottom of the form.
Basic (from 15 €)
Premium (from 25 €)
Gold (from 40 €)
My total annual donation amount in €
*
You have a donorpackage from 15, 25, or 40 euros, but it is possible to donate a higher annual amount.
Your answer
My banking number (IBAN)
*
Your answer
I agree with the processing of my personal-, contact-, and paymentdetails
*
Please send changes as soon as possible to
secretaris@vitalis.org
. The authorization to withdraw the annual amount can be canceled before the 1st of December via the secretary. The full privacy statement can be read on
https://www.vitalis.org/en/pages/privacy-statement
.
Yes
Required
Attached file: Overview Donorpackages
A copy of your responses will be emailed to the address you provided.
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