Date of Birth
I hereby apply to join the Kleiner Wukensee e.V. as a sponsoring member (»Fördermitglied«).
I will be paying a monthly contribution of
I'll set up a standing order:
Kleiner Wukensee e.V. DE31 4306 0967 1117 5295 00 (GLS Gemeinschaftsbank Bochum - BIC: GENODEM1GLS)
I'm issuing a direct debit mandate.
Please collect my contribution from the following account:
I agree with the collection, processing and use of the above personal data exclusively by the Kleiner Wukensee e.V. for the purpose of member administration also by means of electronic data processing.