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Kunsthalle
Lingen

◤ Declaration of accession

Registrations via this form are only valid after we confirmed them.

Conformed registrations are binding unless you cancelled it at least 14 days prior to the event.

Fields marked with * are mandatory.

Contact information

Forename *

Surname *

Phone *

Mobile

E-Mail *

Straße, Nr. *

ZIP Code, City *

Payment information

I hereby allow the Kunstverein Lingen to collect the membership fee via bank collection from my bank account.
Authorization for collection via direct debit.
Creditor identification number: DE94ZZZ00001053055
Hereby I authorize the Kunstverein Lingen to collect payments from my bank account via direct debit. Additionally I instruct my bank institute to process the SEPA direct debit orders from the Kunstverein Lingen.

Bank account owner is the same as the contact person

Bank account owner

IBAN

BIC

Bank institute

Sonstiges

Membership fee in Euro:
Pupils, Students, Trainees 12 Euro; Single person 45 Euro, Family/Couple 60 Euro, Other fee:

Verification *

◤

KunsthalleLingen

◤ Declaration of accession

Kunsthalle
Lingen