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iDeal Formulier

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Name:

E-mail:

Address:

Postal code:

City/Town:

Phone number:

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Prepared to help as volunteer with activities of the association

Annual direct debit

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Accept terms and conditions

Membership for €25.-

Totaal: € -

Bank Transfer

Please fill out the form below. After registration you'll get payment instructions.

All fields required (some form elements could not be translated)

First name*

Surname*

E-mail:*

Address (street+house, postal code+town/city)*

Phone Number*

Register as:*

Prepared to help as volunteer with activities of the association*

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