Membership / Donation Form

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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!

I wish to *

(you can select as many choices as you wish from the list)

Become a member (or renew my membership) for 2013

Donate money

Apply to be considered as a Board Trustee (elections take place at the annual General Assembly of all members and all candidacies are welcome)

I am paying 2d4b using *

(please specify the means of your payment)

Bank wire transfer (2d4b's preference)

French bank check (no fee)

Paypal (1,4% fee taken by Paypal)

Required

I wish to pay *

(please specify the amount)

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50 €

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Other:

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My name is *

(please write first and last names)

My email address is *

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