Membership / Donation Form
The charity « 2d4b: invite diversity, nurture dialogue, for, being the change» supports:
- expression and listening of publics usually little ot not at all taken into account,
- sharing of opinions so a nuanced, sensitive and anchored collective intelligence emerges.

This form is for supporters of 2d4b who wish to either become members, or donate to our endeavor.
Thank you for your generosity!
Sign in to Google to save your progress. Learn more
I wish to *
(you can select as many choices as you wish from the list)
I am paying 2d4b using *
(please specify the means of your payment)
Required
I wish to pay *
(please specify the amount)
Required
My name is *
(please write first and last names)
My email address is *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of 2d4b. Report Abuse