Magen David Adom Nederland | MDA-Nederland.nl

Woensdag, 08 Februari 2012 | 15 Shevat, 5772  
Stichting Magen David Adom Nederland (Israëlische Rode Davidster) מגן דוד אדום
Home MDA Nederland DONATEUR: Donateurskaartje aanvragen
DONATEUR: Donateurskaartje aanvragen

Donateurs Badge Zoals u hebt gelezen in de laatste rondzendbrief 83 kunt u na invulling van onderstaand formulier het donateurskaartje(s) voor uzelf en voor uw partner aanvragen.

Deze plastic kaartjes worden door MDA Israël uitgegeven op naam.

De kaartjes geven recht op de diensten die door MDA Israël worden gegegeven en zijn gratis. Zoals het vervoer per ambulance en het geven van eerste hulp op de MDA-posten.

Vul onderstaande formulier in om uw persoonlijke donateurskaart aan te vragen.

Let op:
Uw donateursnummer wordt gevormd door de laatste vier cijfers van het betalingskenmerk op uw acceptgirokaart.
 

Aanvraagformulier Donateurskaart

Vul hier uw land in als dat niet Nederland is.  
Voer hier uw voornaam in.  
Voer hier uw achternaam in.  
Voer hier uw volledige adres in.

Dus straat plus huisnummer plus de eventuele toevoeging.  
Voer hier uw postcode in.  
Voer hier uw woonplaats in.  
Vul hier uw land in als dat niet Nederland is.  
Voer hier uw telefoonnummer in.   Laatste 4 cijfers acceptgiro.
Voer hier uw e-mail adres in.   Indien u uw e-mail adres opgeeft gaat u ermee akkoord dat Magen David Adom Nederland u mag benaderen per e-mail.
 
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