By fax to: Thomas Drunkenmölle: 0 49 (0) 25 71 – 93 06 33
or by letter:
To GrevenGrass e.V.
c/o Thomas Drunkenmölle
Emsdettener Straße 2
48268 Greven

I would like to support the association with a donation:

One time
in the amount of _ Euro.

I need a donation receipt.
(former: donation receipt, delete if necessary)

I confirm that I want to donate.

Place and date: _________________________

Signature (donor): __________________

Direct debit authorization:
I agree that my membership fee and if applicable my
donation(s) will be debited from my account on the respective due date.
I can withdraw from this agreement in writing at any time.

Account holder: __________________________________________________________

Account number: ___________________________________________________

Bank code: _____________________________________________________________________________________________________________________________________________________________________________________________________

Credit institution: ____________________________

I will immediately inform you in writing of any changes to the bank details, fees
for return debits due to incorrect information or insufficient funds
…I’ll reimburse the club.

I agree to participate in the direct debit procedure.

Place and date: ___________________________

(account holder): _________________________