Formulari d’adhesió a la FCCSM

APPLICATION FORM

Friends of the CCSM Foundation

Personal Data

Name and Surname *

National Identity Document / National Identity Number *

Address *

Zip Code *

Population *

Mobile Phone *

Email *

ACCREDITATION MODE

I want to be part of the Friends of the Catalan Congress of Mental Health Foundation.

Annual contribution

Individual quota: 70 €

Collective fee / entity: €150

Another amount

Write your annual contribution (over €70): *

Direct Debit

Account holder *

Holder's ID/Tax ID *

Current Account (SEPA-formatted IBAN) *

CONSENTIMENTS

TAX INFORMATION

Contributions to the Foundation may be eligible for tax deductions as provided for in current legislation.
The Foundation will issue the corresponding tax certificate for donations.

Thank you for contributing to advancing mental health, thinking, and social engagement from the Catalan Congress of Mental Health Foundation.

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Fundació Congrés Català de Salut Mental | c/ Aragó, 141 – 143, 4th floor | 08015 – Barcelona | 93 238 62 47