Financial Contribution
Menber/Volunteer Registration form
Return
I wish to make evident my identification with, and support of, the humanitarian aims of Las Palmas Acoge.
Name and Surnames
Tax Identification N º
Address
P.C.
Locality
Province
Email
Telephone
In the case of contributing my personal and/or professional help as a volunteer, I would wish to do so in:
Las Palmas de G. C.
Vecindario (Sur Acoge)
Arrecife (Lanzarote Acoge)
Financial Contribution
I wish to contribute:
Euros
Monthly
Every 3 months
Every 6 months
Annually
Las Palmas Acoge: Tecén, nº 52 2º 35009 Las Palmas de G.C.
Dear Sirs: Please charge to my account/savings account, until further notice, the amounts presented by Las Palmas Acoge.
Account Holder
Bank or Savings Bank
Customer account code (20 digits)
Date
Day
Select Day...
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Months
Select Month...
January
February
March
april
may
june
july
August
September
October
November
December
Year
I am in agreement with all the conditions:
Acceptance
