Please print, fill in and sign this document and afterwards mail it to STOLPERSTEINE IN KASSEL e.V.

Wilhelmshöher Allee 167, 3412 Kassel  Germany

 

 

I wish to become a member of            Stolpersteine in Kassel e.V.

 

Surname ……………………………………….

 

Name …………………………………........

 

Date of Birth …………………………………………………….

 

Postal Code and City ……………………………………..……………..

 

Street .............................................................................................

 

Telephone ……………………………………….……………

 

Mobile ...………………………………………….........

 

E-Mail ...................................................................

 

 

Annual membership fee - natural persons  .............................................30 €    O

Annual membership fee - reduced ..........................................................20 €    O

Annual membership fee - legal persons................................................100 €    O

Annual membership fee - voluntary............................................................. €    O

 

I have read and agree with the society’s articles (see below) and membership fee regulations.

 

Payment of the membership fee is made

 

O      by means of debit entry BIC: ......................................

 

        IBAN ........................................................

 

O    via bank transfer        

      BIC HELADEF1KAS             IBAN: DE80 5205 0353 0001 156

 

 

 ....................., the ...............         ..................................................................................

    (town)                                 (date)                                          (Signature)