Yes, I would like to become a member in the

as a major company

for

EUR 150,00 per year

 

as a small or medium-sized company

for

EUR 70,00 per year

 

as an individual member

for

EUR 50,00 per year

 

I will pay this amount:

  annually

 €

 

  quarterly

 €

 
monthly

 €

 

 I will pay this amount by:

   standing bank order

 

   Direct debit authorisation
(please send me the necessary forms)

 

Sender and new member of the ALAVANYO e.V.

 Company:

 Name:

 First name:

House number and street

Town /City and Postal code:

 E-mail address:

Empfänger:   

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

Winterhuder Weg 29
D-22085 Hamburg

by fax:   +49 (0)8042 / 564427