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Online donation by direct debit
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Online donation by direct debit
Amount
30 EUR
50 EUR
100 EUR
Other amount
Frequency:*
once
once every two months
once every quarter
once every six months
annually
Personal details
private donation
company donation
Title*
Mr
Mrs
Family
Company
First name*
Last name*
Street, No.*
Postal code/ City*
Email:
Account details
Account holder*
Account number*
Bank code*
Name of bank*
Intended purpose
I would like to give support wherever help is most needed.
Other purpose (please note this under “Comments”)
Comments:
I/We hereby authorize AVC to debit the above amount from my/our account. This may be cancelled at any time.
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