Application for membership

info.apariv@gmail.com

_{I can't save all the dogs in the world, but I can save the whole wourld of one dog!}

logo tierhilfe 300

The annual contribution is at least 36 €. The membership can be cancelled in writing at any time without giving reasons. The membership fee is to be paid into the account named below, unless you have given permission for direct debit.

APARiV, IBAN: ES86 2100 2951 3702 0001 5277, BIC: CAIXESBBXXX

Data protection notice: By sending the membership application, the applicant agrees that the Verein Tierhilfe "Kleiner Brunnen" e. V. stores all data concerning this. The data will be used exclusively for internal association matters.

Regarding data protection we refer to the data protection declaration of the association APARiV.

*Required information.

This is a security field. If you want this form being sent leave the following email field blank:

Last name *

First name *

Street, house no. *

Postcode Place of residence *

Date of birth *

Phone number fixed *

Phone number mobile

eMail *

Country *

Family members (names)

Active membership? *

What tasks would you like to perform?

My annual contribution is € *

Family contribution €

Total contribution € *

I would like to make my payments for APARiV by direct debit and hereby authorise APARiV to make the direct debit for the listed payments. I am aware that I can revoke this authorisation in writing at any time without giving reasons! *

The collection of the membership fee should take place

annually (on 01.01. each year)

quarterly (on 01.01., 01.04., 01.07, 01.09. of the year)

monthly (on 1st of the month)

Account holder

IBAN

BIC

Bank

I have read the data protection notice and agree to the storage of my personal data in accordance with the data protection notice *

Place *

Date of application *

Virtual signature *