Date:*

Name:*

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Adress:*

Postal code:*

City:*

Country:*

Phone:*

Your email*

Gender:*
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Age group:
< 1010-1718-2526-3536-50>50
Type of sponsorship request:
I like to become a member of NGO Simba and / or I want to sponsor the organisation a different way:I want to sponsor for at least 5 euro per month*Advertisement (to be discussed)EquipmentProducts (to be discussed)I want to sponsor the organization once with an amount of

You can transfer the amount of your sponsorship to our bank account: 
Account number NL 95 ASNB 8850 6105 13
ASN BANK
SWIFT CODE ASNBNL21
THE NETHERLANDS

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