Inscription form - cooperation member

CHAMBBÀA - Cooperación Internacional

Avda de las Acacias, 29 - 03600 Elda, Alicante
Tel. 669 574 011

If you wish, you can make a donation by bank transfer or deposit account. You only have to indicate your name and surnames, in our Banesto account:

ES44 0030 3024 50 0001785271

If not, fill the inscription form as a cooperation member below these lines.

Personal data

Name and Surnames *

N.I.F. *

Birth date *

Contact data

Phone *

E-mail *

Address *

City *

Postcode *

Province *

Money input

I wish to donate...*

Bank data

Account holder *

C.C.C. *

By submitting this form you authorize the processing of personal data voluntarily provided to the provision of services by CHAMBBÀA. The data provided by this form will be recorded in a computerized file of CHAMBBÀA. Thus, members can exercise their rights of access, rectification, cancellation and opposition of their data, addressing to the responsible for the file by email or by letter to CHAMBBÀA, Avda de las Acacias, 29-03600 Elda, Alicante.

We will send you a copy of this form to the email address provided.

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