Associate form

Personal data

Name and surnames:

ID card:

Address:

City:

Postal Code:

Province:

Phone number:

Email:

I want to collaborate

With a donation in Euros of:
51015Other

Periodicity:
MonthlyQuarterly (Min 15€)

Direct billing

Owner name:

Account number:

I don't want to receive to my email regular information about Smiles on the Way activities.

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I readed and accept the privacy policy

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