I wish to donate to the ALAVANYO E. V.
Donor:

 Company:

 Name:

 First name:

House number and street:

Town/city and postal code:

 e-mail:

The following amount

25,00 EURO

 

100,00 EURO

 

50,00 EURO

 

125,00 EURO

 

75,00 EURO

 

 

 

Do you require a Charitable Donation Certificate?

yes

 

no

(For a donation of up to 50.00 EURO the Inland Revenue Office in Germany accepts a statement of account or a receipt.
If you require a Charitable Donation Certificate, please fill in your full name and address:)

Registration in our list of donors?

yes

 

no

Please send your donation by bank transfer to:
Empfänger:   
Or print out this form and send it by post or fax to

Kardinal-von-Galen-Str. 19
D-48712 Gescher

per Fax:   +49 (0)2863 / 7193202