Ugarit Verein e. V. - Humanitarian Aid for Syria

Membership Application

Please note that this step is solely intended to assist you in preparing the printed version of the membership application. After clicking "Create PDF file", you will be redirected to a PDF form that you must sign and email to contact@ugarit-ngo.org.

First Name: *

Last Name: *

Titl:

Profession:

Address: *

Postal Code:

City: *

Phone: *

Fax:

Email Address: *

Direct Debit Authorization

I hereby authorize the Ugarit Verein e. V. Humanitarian Aid for Syria to withdraw my annual membership fee of 60 EUR from the following account until revoked

Account Holder:

Bank Name:

IBAN:

BIC:

* indicates required fields