Donor enrollment form

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Dear Sir/Madam,

Would you like to stay updated on the activities of the study association Di-Et-Tri? This is possible by becoming a donor of the association. Donors are essential for our association to maintain financially healthy and keep on providing activities and other services to our members.

A distinction between two types of donors can be made. We have yearly donors and one-time-only donors. If you would like to make a one-time donation, please fill out this form.
Donors whom donate yearly receive the four editions of the association magazine, The Health Issue. The Health issue informs our members and donors about everything that happens within our association and the Nutrition and Health programme. Furthermore yearly donors recieve the donorletter, which provides an overview of the association year. Lastly, donors may choose to recieve our weekly mail, the Foodflash. If you would like to become a yearly donor, please fill out this form.

For questions, please contact us via diettri@wur.nl.

Kind regards,
Di-Et-Tri Board 2023

Iris van brugge

Amber Smulders

Irene Vereecken

Pien Coenen

Merel van der Eijk

Annemijn Crousen

Study association Di-Et-Tri
Droevendaalsesteeg 2; kamer 110, bode 818
6708 PB Wageningen, Nederland

IBAN: NL06 RABO 0120 2057 42
Incassant ID: NL08ZZZ401238840000
K.v.K. nr. 40123884 Arnhem

Website: www.diettri.nl
E-mail: diettri@wur.nl
Phone: 0317-484270

First name *

Last name *

E-mail *

Address *

Postal code *

Donation amount *

A yearly donation of €25,-

A yearly donation of €50,-

A yearly donation of €100,-

A yearly donation of €200,-

Other:

Prefered payment *

Preauthorized debit (the amount will be withdrawn automatically)

Transfer

Bank account (IBAN) *

In the name of *

Prove of authorization *

With this registration form I will authorize the study association Di-Et-Tri to withdraw the chosen amount of money yearly from the given bank account, until my written or emailed cancelation

With this registration form I state to transfer the chosen amount of money yearly, until my written or emailed cancelation.

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