Surname *
First name*
Birthday *
Street, house number *
ZIP, City *
Email *
Phone/Mobile *
Fax
Please leave this field empty.
Job
parrot holder * YesNo
I am particularly interested in:
my membership in the Vogelburg-Club.
Annual fee * € 25,-- (individual)€ 50,-- (family ticket)€ 75,--€ 100,--Other amount
to pay. The contribution is paid once a year by direct debit.
Account number *
Bank code *
Account holder name *
IBAN *
BIC *
The move-in should take place for the first time on *
If the specified account does not have the required funds at the time of collection, the bank holding the account is not obliged to redeem it.
I agree that my details from the contact form will be collected and processed to answer my request. Detailed information on handling user data can be found in our data protection declaration. *
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