Kinderpatenschaften Formular



Yes, I would like to become a personal sponsor for.

I would like to become a sponsor for

Please, send me first a suggestion for a sponsorshop to my adress.

I will donate an amount of : EUR.
(The monthly minimum amount for a sponsorship is 30,00 EURO.)

Sender:

Company:

Name:

First name:

House number and street::

Town/city and postal code::

e-mail:

I will pay this amount:


	I will pay this amount by:

standing bank order
Edirect debit authorisation (please send me the necessary forms)

or please print out this form and send it by post or fax to


	Kardinal-von-Galen-Str. 19 D-48712 Gescher Germany per Fax: +49 (0)2863 / 7193202