I apply for membership as ordinary member in the association Stepic CEE Charity. Type of Membership * Membership (€ 50 p.a.) Additional single donation of: € I will pay the fee into the association‘s account: H. Stepic CEE Charity BIC: RLNWATWW IBAN: AT483200000000100099 Membership data First name: * Last name: * Address: * E-Mail Address: * Date of Birth: Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year192419251926192719281929193019311932193319341935193619371938193919401941194219431944194519461947194819491950195119521953195419551956195719581959196019611962196319641965196619671968196919701971197219731974197519761977197819791980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010201120122013201420152016201720182019202020212022 Direct debit authorisation I authorize the association to annually collect the membership of € 50 fee by direct debit: Bank: BIC: IBAN: Agreement I agree to the processing and storage of the data mentioned above for internal administration purposes. This permission can be withdrawn at any time by written notice. The membership can be terminated with immediate effect at any time by informal notice of resignation via mail or e-mail. H. Stepic CEE Charity, association to support charitable projects in Central- und Eastern Europe, listed in the registry of associations under the ZVR number: 522188386. If you have any questions, please send them to info@stepicceecharity.org. Leave this field blank Printer-friendly version