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Formulatio de Donación
With your donation you will bring an effective and powerful symbol of love and hope into this world. You'll help to alleviate human misery in the mountain valleys of Peru.

Download Donation Form




I want to take a monthly sponsorship of a child.
$35*   $70*   $85*
$140*
$210* (full sponsorship)
I want to take a monthly sponsorship of a student.
$50*
I want to take a monthly sponsorship of a teacher.
$140*
I want to sponsor an entrepreneur with a donation
$300*   $
I want to support the various projects of "Corazones para Peru"
with an amount of $.
einmalig   monthly*   quarterly*   yearly*
I want to receive more information about the project.
     * recurrent donations can be terminated at any time.

Title: 
 *
Company: 

Profession: 

First Name: 
 *
Last Name: 
 *
Address: 
 *
ZIP-Code: 
 *
City: 
 *
Phone: 
 -  *
Fax: 
 - 
E-Mail-Adress: 
 *

                              * Fields marked with a red asterisk have to be filled out.
Account Owner: 
 *
 
either Name of Bank / Account No / Bank Code No
Name of the Bank: 
 *
Account Number: 
 *
Bank Code Number: 
 *
 
or IBAN / BIC
IBAN: 
 *
BIC: 
 *
 I hereby agree to the processing of my data. *


Número de Seguro:
 14154


 



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