Inscription form - cooperation member

CHAMBBÀA - Cooperación Internacional

Avda de las Acacias, 29 - 03600 Elda, Alicante
Tel. 669 574 011
info@chambbaa.org

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:

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 info@chambbaa.org 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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