change of member status/membership fee

Change of Member Status or Membership Fee

Please note:

If you do not have a bank account in Europe, please use an other registration form.
By subscribing this registration form, you accept the condition for foring membership.
Please use English terms and English letters (do not use ü, é, etc.).

Name (!) *

Vorname

Nachname

E-Mail-Address (!) *

Adresse *

Position 1

Position 2

Stadt

Region

Postleitzahl

Land

Phone-Number *

Comment *

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Change of member status *

I would like to change my member status in order to become an ordinary foring member. I would like to change the amount of my membership fee.

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Amount of membership fee (in Euro per year) *

Name of account holder *

IBAN (international bank account number) *

Name of the bank *

BIC (bank identifier code) *

Creditor/Zahlungsempfänger:

Creditor identifier/Gläubiger-Identifikationsnummer:
Mandate reference/Mandatsreferenz:

foring - Forum für Internationale Gesundheit
Forum for International Health
Taxisstr. 21 - 80637 München - Germany
DE70ZZZ00001163582
to be completed by foring/wird separat mitgeteilt

SEPA Direct Debit Mandate *

I authorise foring to send instructions to my bank to debit my account and my bank to debit my account in accordance with the instructions from foring. Note: I can, within eight weeks, starting with the date of the debit request, demand a refund of the amount charged. The terms and conditions agreed upon with my financial institution apply.

SEPA-Lastschriftmandat
Ich ermächtige foring, Zahlungen von meinem Konto mittels Lastschrift einzuziehen. Zugleich weise ich mein Kreditinstitut an, die von foring auf mein Konto gezogenen Lastschriften einzulösen. Hinweis: Ich kann innerhalb von acht Wochen, beginnend mit dem Belastungsdatum, die Erstattung des belasteten Betrages verlangen. Es gelten dabei die mit meinem Kreditinstitut vereinbarten Bedingungen.

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I give the mandate / Ich erteile das Mandat.