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Registration form

By filling this form you register as a potential donor and express your interest to support one particular child. To sort out formalities such as the donation contract takes about 2 weeks. If you like to support more than one child or wish to be registered as a group of donors, please don’t fill this form and contact our office for details: adopce@humanitasafrika.cz.

Please fill in the required fields as indicated. Thank you!

Patron
Organization
Main address / org. headquarters
Postal address
Payment

I am already a registered donor database Humanitas Africa and my variable symbol is as follows.

Yearly contribution 5 000,-
Request for sending an receipt for tax deduction purposes.**

* only when paying by bank transfer
** sent in the first quarter of next calendar year