SPOLU PRO ŽIVOT
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ÚVODNÍ
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PODPOŘIT
O PROJEKTU
KONTAKTY
DONATION AGREEMENT / CONFIRMATION
Requested Action:
New donation agreement
Request for confirmation of a donation already made
Name / Company Name:
Street and House Number:
City:
ZIP Code:
Preferred Regional Support (Czech Republic):
Praha
Stredocesky kraj
Jihocesky kraj
Plzensky kraj
Karlovarsky kraj
Ustecky kraj
Liberecky kraj
Kralovehradecky kraj
Pardubicky kraj
Kraj Vysocina
Jihomoravsky kraj
Olomoucky kraj
Zlinsky kraj
Moravskoslezsky kraj
Email Address:
Phone Number:
Amount:
Currency:
CZK
EUR
USD
Date of Donation:
Bank Account Number (from which donation was sent):
SUBMIT REQUEST
