Fields marked with * are mandatory.

I'm of age YesNo


Who are you?

PrivateCompany


Name/Company Name and Identity Card Number



Contact

Home



Your contribution

Amount *: euros   ·   Regularity *:

from month /

Debit

Bank account I.B.A.N


Deduction from Income StatementCompany Tax

I want to receive the certificate for the I.R.P.F.Company Tax purposes NoYes

If yes, please fill in your Identity Card Number and your Zip Code.



Other Information

Enter this text:
captcha

(By submitting this form you agree to the Terms and Privacy Policy below)

By submitting my information I authorize Delwende “at the Service of Life” to charge my membership fee in the bank account indicated above.

According to the provisions of Law 15/99, Protection of Personal Data, the data will be incorporated to file of Delwende "at the Service of Life", registered in the Spanish Agency for Data Protection with the number 2,030 .990.591 and to facilitate direct debit and compliance with legal obligations. At any time the data can be accessed, corrected or canceled by the trader in Delwende "al Servicio de la Vida" Plaza Madre Molas 1, 280346, Madrid (Spain).


Or if you prefer...

You can also get off this form and return it to us filled out to Delwende al Servicio de la Vida. Plaza Madre Molas 1 - 28036 Madrid (Spain) or send it by email to socios@delwende.org.

 

As contained in our statutes, minors must have parental consent or the person exercising parental authority or guardianship.

You can contact us by going to Members and donors on this website to complete your membership status.