Welcome » Benefactor

Benefactor

I would like to show solidarity with the actions carried out by the Association by contributing financially.
I pay the amount of my choice by transfer or check payable to “L’ASPIC”

Price:

First Name:* First Name Required

Last Name:* Last Name Required

Address Line 1: Address Line 1 is not valid

Address Line 2: Address Line 2 is not valid

City: City is not valid

Country: Country is not valid

State province: State/Province is not valid

Zip/Postal Code: Zip/Postal Code is not valid

Phone:* Telephone is Required

Date of birth: Date of birth is not valid

Occupation:* Profession is Required

How did I find out about the Association?:* How did I find out about the Association? is Required

Membership type:* Membership Type is Required

E-mail:* Invalid Email

Password:* Invalid Password

Password Confirmation:* Password Confirmation Doesn't Match

Have a coupon?

Coupon Code:

Invalid Coupon Coupon applied successfully

Description	Amount
Benefactor – Payment	100.00€
Total	100.00€

Select Payment Method

By transfer By cheque

IBAN:
FR76 1780 7000 0245 4193 9194 121

BIC:
CCBPFRPPTLS

payable to: L’ASPIC

No val Please fix the errors above