Application for Membership at Commons & Code e. V.

To whom it may concern,

I hereby apply for membership in the association “Commons & Code e. V.” at the earliest possible date.

Personal Data

Title

Last Name

First Name(s)

Street & House Number

Postal Code & City

Date of Birth

Country

E-Mail Address

Phone Number (optional)

Preferred Communication Language

Membership Fee

The first membership fee is due pro-rata for the current year. The current month will be charged in full.

I grant the association a direct debit mandate (see below) and authorize the board to collect the membership fee regularly, in accordance with the statutes, rules of procedure, and resolutions of the general meeting.

I would like to transfer my membership fee myself or use another payment method. The board will contact me about this.

Amount of Membership Fee

10€ / month (120 € annual fee)

higher monthly fee:

€

I apply for a reduced membership fee according to § 1 para. 2 of the financial regulations

in the amount of: € (min. 2.50 € / month)

for the following reason:

Payment Method of Membership Fee

annually on 1.1.

quarterly on 1.1., 1.4., 1.7. and 1.10.

For minor members

We hereby approve, in accordance with § 108 para. 1 BGB, our child's joining the association Commons & Code e. V.

Legal Guardian 1 (First & Last Name)

Legal Guardian 1 (Signature)

Legal Guardian 2 (First & Last Name)

Legal Guardian 2 (Signature)

Data Protection & Confirmation

Data Protection

We would like to point out that for the purpose of member administration and support, the data from this application will be stored, processed, and used in automated files.

I have taken note of the data protection notice and agree to the processing of my data.

Statutes & Regulations

I hereby confirm that I have taken note of the statutes, the financial regulations, and the rules of assembly of the association "Commons & Code e. V.". I fully accept them by submitting my application. I am aware that the current versions of the documents can be viewed on the association's website or will be made available upon request.

I have read the statutes and regulations and agree to them.

Place & Date

Applicant's Signature

SEPA Direct Debit Mandate

Payee's Name: Commons & Code e. V.

Payee's Address: Cäcilienstraße 6, 04317 Leipzig

Creditor Identifier: DE35ZZZ00002851042

Mandate Reference: [To be filled in by the association]

Account Holder's Name

IBAN

SWIFT / BIC (if abroad)

I authorize the association Commons & Code e. V. to collect payments from my account by direct debit. At the same time, I instruct my bank to honor the direct debits drawn by the association Commons & Code e. V. on my account.

Note: I can demand a refund of the debited amount within eight weeks, beginning with the debit date. The terms and conditions agreed with my bank apply.

Place & Date

Account Holder's Signature