Fields marked with * are mandatory.

Step 1: Indicates the donation type

Donation type

Bank card or PayPal    Charged to

This type of contribution is made ​​through paypal with credit/debit card or your own paypal account.This type of contribution requires a bank account.


Or also

If you prefer to make a direct deposit into the account can do:

Deduction from Income Statement or Company Tax

I want to receive the certificate for the I.R.P.F. or Company Tax  No Yes

If yes, you mus give us the Name that will appear on PayPal


your Identity Card Number      and your Zip Code   

The remaining data required will be requested in paypal.


By clicking the button you will be redirected to paypal to make your donation with credit/debit card or your own paypal account.

Enter this text:
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Who are you?

 Private Company


Name/Company Name and Identity Card Number



Contact

Home



Your contribution

Amount *: euros   ·   Regularity *:

from month /

in the 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  No Yes

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



Other Information

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By submitting my information I authorize Delwende “Al servicio de la vida” to charge my donation in the bank account indicated above.

By submitting my information I authorize Delwende “at the Service of Life” to charge mydonation 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 28036, Madrid.


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.