I hereby apply for supporting membership of the Friends of HIDALGO e.V.

Desired entry date*

Date of birth*

First name*

Surname*

Street and house number*

Postcode*

Place*

E-mail address*

Telephone number*

As a sustaining member, I support the Friends of HIDALGO e.V. and its purpose, in particular the promotion of HIDALGO, its events and productions.

I can choose from the following sponsoring membership levels depending on the amount of my contribution:

• Barón or Barónesa: from 168 euros per year
• Hidalgo or Hidalga: from 84 euros per year (with discount entitlement*: 36 euros)

As an annual sponsorship contribution I pay (Euro):*

*Those under 30 years of age, school pupils, trainees, students, people with severe disabilities, Munich Pass holders or holders of comparable concessionary entitlements are entitled to a discount.

(I will receive a donation receipt for donations of 200 euros or more; smaller amounts can be claimed for tax purposes by means of a bank statement).

For this purpose, I authorize the Freundeskreis des HIDALGO e.V., formerly HIDALGO e.V. and HIDALGO Community e.V. (creditor identification number: DE80ZZZ00001998669) to collect payments from my account by SEPA direct debit. At the same time, I instruct my bank to redeem the direct debits drawn on my account by the Freundeskreis des HIDALGO e.V.. I will bear the costs incurred in the event of insufficient funds in my account.

Note: I can request a refund of the debited amount within eight weeks of the debit date. The conditions agreed with my bank apply. The mandate reference number is assigned individually.

Name of the account holder*

Bank*

IBAN*

BIC*

I agree that the Freundeskreis des HIDALGO e.V. may electronically store and evaluate the data I have entered for the purpose of payment processing and member support. My data will not be passed on to third parties without my consent. All information will be treated confidentially by the Freundeskreis des HIDALGO e.V..

Place*

today's date*

Δ