Forms

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Fördermitgliedsantrag

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Membership Form

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Patenschaftsformular

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Child Sponsorship Form

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Membership Form

1. Personal information

First name * Last name * Date of birth * Street and house number * Postal code and place of residence * Country * Phone number * E-mail address *

2. Type of membership

Type of membership * Supporting member

Desired start of membership *

3. Membership fee (€5 per month)

Desired standing order * Monthly: €5 Quarterly: €15 Annual: €60

Method of payment * Bank transfer (standing order)

4. Motivation and commitment

Why do you want to become a member of HCI?

5. Declarations and consents

I hereby apply for membership in HCI and accept the applicable statutes and the terms and conditions of membership of the organization. * I confirm that my information is complete and correct. * Privacy notice: I agree that HCI may store my personal data (name, address, e-mail address and telephone number) electronically. My data will not be passed on to third parties. I can revoke my consent at any time. * City *

* Required. Date and time of submission are recorded automatically and replace the handwritten signature.