Donation replacement chromium-6

Do algae replace chrome-6?

Yearly donation

Yes, I support research into algae as a replacement for chromium-6.

Replacement chromium-6?

Donation via SEPA Direct Debit

I, HEREBY AUTHORIZE DELFT UNIVERSITY FUND TO (UNTIL FURTHER NOTICE) WITHDRAW THE FOLLOWING AMOUNT FROM MY ACCOUNT

€50,-

€100,-

€200,-

€500,-

Other amount of

Periodic

Yearly,

Each quarter

Name

Street and number

Postal code

City

Phone number

E-mail

IBAN

NEWS

I would like to be informed by e-mail about the activities of Delft University Fund

Permission

By submitting this mandate form, I authorise Delft University Fund to send (recurring) instructions to my bank to debit my account. I authorise my bank to debit my account in accordance with the instructions from Delft University Fund.

Don't fill this field!

If you do not agree with a direct debit, you can have it returned. Please contact your bank within 8 weeks of the direct debit and ask for the conditions. The direct debit ID from Delft University Fund is NL44 ZZZ 4114 5319 0000.

Fields with a * are necessary to process your donation.

Personal data
Delft University Fund uses your data to process and record your donation and to inform you about the activities and work of the University Fund. Your personal details will be treated confidentially in accordance with the Dutch Personal Data Protection Act and will never be provided to third parties.