Collaborate

BY THE TIME THIS FORM IS OUT OF SERVICE

If you would like to get involved with the Fundació ADA, per al Desenvolupament del Adivasis send an e-mail to contacta@adivasis.org with the following information:

Name
Last Name*
Adress
City*				Zip code
Profession
Phone			Date of birth (dd/mm/yy)
E-mail
D.N.I.
Payments Choose frequency monthly quarterly yearly only contribution
Amount		€	20€	30 €	60€
Method of payment
Transfer to CAIXA DE CATALUNYA - 2013 0248 44 0200629785
Through the bank
	Name
	Bank
	Account
Date you send the form dd/mm/aa
How did you learn about ADA?
		Friend or acquaintance
		web
		Exposition/Activities
		Other
Are you willing to collaborate regularly or sporadically with the foundation projects?
Comments: