DONATIONS REGISTRATION FORM

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Register here to become a donor

Individual membership (CHF 50/year)

Donor (from CHF 300/year)

One-time donation (any amount)

I would like to get involved!

Last Name

First Name

Address (Street, No. / ZIP/City)

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Thank You!

Contact:

Dachverband angeborene Herzfehler Schweiz

Lange Gasse 78

4052 Basel

Donation account:

Raiffeisenbank Basel,
IBAN: CH44 8080 8009 1584 4685 7
Account holder: herznetz.ch

Mobile (+41) 079 459 44 55

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