Support form Umutima Foundation

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Lastname *
Salutations *Mr
Full Address
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Phone no
E-mail *
Would you like to receive the Newsletter? *yes
Bank account number (IBAN) and BIC Code *
I hereby authorise the Umutima Foundation to deduct the following amount from the specified bank account: *every month
every quarter
every year
once only
Amount *
Starting on (until the authorisation is cancelled): *

Fields marked with * are mandatory.
You will receive a confirmation e-mail.
Send an e-mail to to change or end the authorisation.
Any amount deducted on the basis of your direct debit authorisation can be cancelled and returned to your account within 8 weeks.