Membership Application - Sphere Radio - leipzig kultur hören

Membership Application

First name*

Last name*

Business name

Birthday*

E-Mail*

Street*

Postcode*

Location*

Country*

Telephon

MEMBERSHIP

Supporting member (€ 4.00 month, € 48.00 year / reduced * € 3.00 month, € 36.00 year)

Full member (€ 4.00 month, € 48.00 year / reduced * € 3.00 month, € 36.00 year)
Participation in general assembly, right to vote and speak

Active member (€ 4.00 month, € 48.00 annually / reduced * € 3.00 month, € 36.00 year)
Participation in general assembly, right to vote and speak
Active participation

Legal person (contractually regulated)
Participation in general assembly, right to vote and speak

* (Pupils, trainees, students, retirees, unemployed, needy, people with disabilities)

Please choose your wanted membership:*
supporting member (4 € / month)supporting member (reduced, 3 € / month)legal personactive Member (€ 4 / month)active member (reduced, € 3 / month)

You can find more information about the memberships here.

Exemption from contributions (only for legal persons).

Entry date*

Debit rhythm

Execution date

BANK ACCOUNT

IBAN*

BIC*

Bank / Credit institute*

Account holder*

I authorize the Sphere Radio e.V. association to collect payments from my account using SEPA direct debit. At the same time, I instruct my bank to redeem the direct debits drawn on my account by the Sphere Radio e.V. association.
I can request reimbursement of the debited amount within eight weeks, starting with the debit date. Applicable in this regard by the contract with my bank conditions.

You agree that your data will be used to process your request. You can find further information and revocation instructions in our Data protection consent and in the information on the processing of your data.

I recognize the Statutes & the self-image of the Sphere Radio e.V. binding.

I agree to receive the newsletter.