التبرع السنوي

Your full name *

Your email address *

Membership *

• Membership for myself – minimum 26 euro per year (per year)
• Membership for myself – minimum 3 euro per month (per month)
• Membership for myself, plus give a membership to a patient – minimum 52 euro per month (per year)

Amount *
€

Authorisarion and payment method *
Card PayPal iDEAL Bancontact KBC/CBC Payment Button Belfius Pay Button Bank transfer
I hereby give authorization to collect the recurring amount from my account periodically.

I agree to the Privacy Statement of the LGD Alliance Europe. *

Register and pay