Doneren Name* Company name Email address Street Zipcode City Country Project* VechtdalCup-JohanSeckelSchool Message Amount () *5,0010,0015,0020,0025,0030,0035,0040,0045,0050,0075,00100,00250,00500,001000,002500,00 I hereby authorize to collect the amount shown above from my account periodically.
