Name and Surname:
Age:
Miss
Mrs
Mr
Nationality:
Address and City of residence:
Contact #:
E-mail:
Profession:
You would like to donate €:
TO SUPPORT:
Food provisions Ramadan 2010
'A doctor for the islands' project
Children Education
The H.E.L.P. Association
Comments and further affinities:
Wire transfer:
Contact us at
infos@helpassociation.org
to aknowledge our bank info.
Donations by non-endorsable cheque payable to: H.E.L.P. ASSOCIATION
To be sent to (by priority mail service) :
H.E.L.P. – C/O Mrs Cicarini
5 Bd Camille Flamarion/Bat.5 - 13001 Marseille - FRANCE
