Formulier 2B – STERK

Voornaam

Tussenvoegsel

Achternaam*

E-mail

Ik steun AMBER Alert graag:

• One-off
• Monthly

Hoeveel wil je doneren?*

€ 

Hoeveel wil je doneren?*

• €2.00
• Other: €

Method of payment*

• Direct debit
• iDeal
• Bancontact
• Credit Card
• Paypal

I agree that AMBER Alert Europe periodically instructs my bank to debit the promised amount from my account. I also agree with the regulation of the European SEPA direct debit system*

Bank account number*

IBAN

BIC

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