By means of the form below, you can register for a periodical or one-off direct debit to support A Seal. If there are any questions, email firstname.lastname@example.org.
Name and surname
ZIP code and address
(Mobile) Phone number
Direct debit mandate ID A Seal: NL25ZZZ6019911640000.
Payment reference: this will be filled in by A Seal and will be provided to you.
I authorize the foundation A Seal Stellendam and Expo to pay:
MonthlyYearlyOne-off of an amount of
Euros from the account notified above.
When you press send, you mandate the direct debit as described above. Thank you very much for your contribution.