Donation by direct debit

  1. Personal details
  2. First Name *
    *
  3. Last name *
    *
  4. Street *
    *
  5. Street number *
    *
  6. Number
    *
  7. Floor
    *
  8. Postal code *
    *
  9. City *
    *
  10. Country *
    *
  11. Phone number *
    *
  12. Others
    *
  13. Email *
    *
  14. Type Identification *
    *
  15. NIF/CIF *
    *

  16. I want to work with a contribution of:
  17. Choose amount *
    *
  18. Amount *
    *
     €

  19. Frequency
  20. *




    *

  21. Bank account details
  22. Account holder *
    *
  23. Type of account *
    *
  24. IBAN *
    *
  25. *
    *
  26. *
    *
  27. *
    *
  28. *
    *
  29. *
    *
  30. BIC/SWIFT *
    *
  31. Entitat *
    És necessari el codi de l'Entitat
  32. Oficina *
    És necessari el codi de l'Oficina
  33. DC *
    És necessari el Dígit de Control
  34. Nº de Compte *
    És necessari el número de compte

  35. Recorda que pots desgravar en la declaració de la renda. Per a això, és imprescindible que disposem del teu NIF/DNI
  36. Si decideixes rebre certificació anual remet-nos aquest formulari degudament emplenat.
  37. Your personal data will be incorporated into an automated file for Por una Sonrisa en Africa to stay informed about our activities. We guarantee that the data are confidential and exclusive use by Por una Sonrisa en Africa. If you wish, you can access them, correct or cancel by writing to Calle Álava 12 – Bajos 1, 08005 Barcelona.
  38. If you do not wish to receive information, check the box:
  39. Invalid Input

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