DSV-Membership application form

Surname *

First name *

Date of birth *

Address *

Post code *

City *

Country *

Phone

Mobile phone

E-Mail *

I don't want a DSV magazine

SEPA direct debit mandate

I hereby revocably authorise DSV e.V. to collect the payments to be made by me at the due date from my account by direct debit. At the same time, I instruct the bank to redeem the direct debits drawn to my account by DSV e.V. Note: I can request reimbursement of the amount debited within eight weeks, starting with the debit date. The conditions agreed with my bank apply.

Last name / first name of the account holder

IBAN of the account holder

BIC

Bank

Payee:
Deutsche Standard-Wellensittich-Züchter-Vereinigung e.V.
Creditor identification number: DE59ZZZ00000076604
Mandate reference: Your DSV number

City *

Date *