Individual Supporting Membership

The Clean Air Action Group is greatly honoured that you would like to become its Supporting Member.

Name:*
Address:*
E-mail:*
Phone:
Date of birth:
Profession:
Type of support:*  
Yearly membership paid in one sum: minimum 11,000 HUF
Yearly membership paid monthly: 1,000 HUF/month
Yearly total:*
Method of payment:  
I transfer the sum to the bank account number of Clean Air Action Group (10700347-49865305-51100005)
Other information:
I would like to help your work as a volunteer.
I would like to appear as a Supporting Member on CAAG’s website and Annual Report.
Please, enter today's date in the following format: yyyy-mm-dd:*

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