Becoming a donor

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Becoming a donor

Thank you for wanting to become a donor of HCSA. Because of your help, we are able to organise the activities and improve the social cohesion among Honours students. If you donate more than €10,- yearly you will receive a spot on our official list of donors. If you want to cancel your donorship, please send an email to board@hcsa.nl.

First Name *

Last Name *

E-mail *

Please provide your IBAN *

Do you agree to the following terms? *

Yes

Required

*By sending this form I authorize the HCSA to initiate debit entries to my checking account at the financial institution listed above, for the collection of premiums on the policy specified, that is €10 per year. Your info will be kept private.

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Rug-honours.nl. Report Abuse

Forms