Join the club

Join the club

Contact details

Name:
Surname:
Tel:
E-mail:
Street and no.:
City/town:
Postcode:

Donations receipt

Would you like us to issue you with a donation receipt for tax purposes?

Natural person - date of birth:
Company No. - IČ/VAT:

My donation - amount in CZK

100,- Kč / month (recommended for students, pensioners, women on maternity leave))
200,- Kč / month
300,- Kč / month
500,- Kč / month
1 000,- Kč / month (recommended for companies, legal entities)
a different monthly donation
Kč

Donation payment method

direct debit
other - please contact me

As a Club member, which of the following would you welcome?

Invitations to the Memorial’s cultural events
Meetings other club members

I would like my name to be included in the list of donors:

On your website 
In your annual report
NI do not want this information to be published anywhere

Anti-spam protection

Current year:

* the current year field protects against spam robots submitting forms

By submitting this form, I agree that Prague Shoah Memorial may collect, store and process the personal data contained in this form. The organization shall manage the provider’s personal data in compliance with Act No. 101/2000, on the Protection of Personal Data for the purposes of Club of Friends member administration; the data will not be provided to other parties.

Act No. 586/1992, the Income Tax Act, enables you to deduct the value of a charitable donation from your tax base. If you want to be issued with a donation receipt for tax purposes, please complete this form.

Once you have submitted your application, we will contact you with the payment details.

Banking details
Fio banka, a.s., V Celnici 1028/10, Praha 1
Bank account number: 2400523272/2010
IBAN: CZ6120100000002400523272
BIC/SWIFT: FIOBCZPPXXX

If you have any questions regarding the Club of Friends, please send an email to: dary@bubny.org.