JOIN US


EXIT-MAGYARORSZÁG
CENTER OF STUDIES AND DOCUMENTATION
ON EUTHANASIA

Tel:0039/011-7707126
0039/330512712

exit-italia@fastwebnet.it

LIVING WILL

How to become a member

fill the application form
- pay the subscription fee
write your Living Will
- send all these documents to exit-Italia
c.so Monte Cucco 144 10141 Torino – Italia

(you shall receive your Living Will with the stamp of the association and your Exit card)
- inform us of your application on line at exit-italia@fastwebnet.it
or by phone: 0039.011.7707.126



Application form


The undersigned………………born in………………………………

Living in………………………address………………………………Town…………

Telephone………………………..Mobile…………….fax………….e mail…………

applies to become a member of the Association as (state your choice):


- Ordinary member: Subscription fee 50 Euros

( subsequent annual fees 25 Euros)

- Member for life : 800 Euros: No fee in the following years.


PAYMENT INSTRUCTIONS


Money Transfer through a Bank:

specify your name, surname, address and our full IBAN

IBAN : IT03 Q 07601 01000 000039167101

BIC: BPIITRRXXX


Legible signature ………………………


Date (handwritten)………………………



JOIN US


EXIT-MAGYARORSZÁG
CENTER OF STUDIES AND DOCUMENTATION
ON EUTHANASIA

Tel:0039/011-7707126-0039/330512712

exit-italia@fastwebnet.it

LIVING WILL