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Mr.

Ms.

Title

Corporation

*First Name

*Last Name

*Country

*Postal Code

*City

*Address

*Status

*Date of birth

*Telephone

Fax

*Email

Direct debit mandate

Recipient: Deutsche Shakespeare-Gesellschaft, Windischenstraße 4-6, 99423 Weimar

Creditor identification number: DE19ZZZ00000028630

Mandate reference number: Will be mailed to you, as well as the date of the first debit transaction.

Round up amount / Donation

Your membership fee is

{math_result} €.

Is the account holder another person?

yes

IBAN

BIC

Mandate

Mandate valid for recurring payment

Mandate for collection of SEPA basic direct debits

I/We authorize the aforementioned payee(s) to collect payments from my/our account by direct debit. At the same time, I/we instruct my/our credit institution to redeem the direct debits drawn by the above creditor to my/our account.
Note: I/we may request reimbursement of the debited amount within eight weeks of the debit date. The terms and conditions agreed with my/our bank apply.

Here you can find our constitution.

If a direct debit payment is not possible, please pay your membership fee into the following account after having received the confirmation of your application as a member:

Deutsche Shakespeare-Gesellschaft
Account No: 0 301 009 503
Bank: Sparkasse Mittelthüringen
Bank Code: 820 510 00
IBAN: DE95 8205 1000 0301 0095 03
BIC: HELADEF1WEM

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*Privacy Police

I have read and understood the privacy policy and agree that the data I provide may be collected and stored electronically. My personal information will only be used for statutory purposes of the German Shakespare Society, as well as for processing and answering my request. By sending this form, I agree to the processing.

Here you can find our privacy policy.