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)