Donorform

Anybody who donates more than 100 Euro receives an autographed book of our ambassador Peter R. de Vries. If you fill in more than 100 Euro's in this form you can see which (Dutch) books you can choose.

First name *

Last name *

Street and house number *

Postal code *

City *

Country

Sex * Male Female

Bank account number *

Phone number

E-mail address *

Date of Birth *

Would you like to receive our newsletter? * Yes No

Remark

Hereby I allow Meet Kate to write off *

the amount of *

Book titel

Autographed for

* mandatory

With one E-mail (administratie@meetkate.nl) you change or stop your donation.

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Donorform