__ I become an official donor of the FGF and will be listed in the published list of donors.
Please send me a donor certificate for
__ $ 300,-
Please send me a donor certificate for
__ $ 3000,- , for which I will also be invited to all public events of the FGF as a special guest of honor.
__ I support the work of the FGF with a one-time donation in the amount of $ ______________
__ Please send me a tax-deductible donation voucher.
__ I become a member of the FGF.
The annual membership fee for full salaried individuals is $
150,- (reduced fee $ 50,-).
I may terminate my membership without notice at any time.
__ I have transferred the amount of $ ______________ to the account of the FGF:
Bank account no.130 650 55, Berliner Volksbank, Hauptstrasse 109
D-10825 Berlin, Germany, Routing code 100 900 00.
__ I am enclosing a cheque in that amount.
Name ____________________________________________
Street ____________________________________________
City _____________________________________________
State __________________________Zip________________
Phone/Fax/Email ___________________________________
Signature/Date _____________________________