Nadace Dagmar a Václava Havlových - VIZE 97

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Financial donation

Financial donation value:	CZK
Propose of donation:	Foundation’s Operation – account number: 2102134586/2700 Prague Crossroads – account number: 2102134789/2700 VIZE 97 Foundation Prize – account number: 2102134658/2700 Cancer Prevention – account number: 2102134674/2700 Fund of Understanding – account number: 2102134690/2700 Education – account number: 2102134711/2700
Antispam control:	1 + 3 =

Do you wish to receive free Annual Report of the VIZE 97 Foundation (once a year)	yes no
Do you agree to your donation, including your name, being published in the Annual Report and on the websites of the VIZE 97 Foundation	yes no

All personal data completed in this form will only be used for issuing the Gift Agreement and, if applicable, for sending the Annual Report once a year, or including the donor into the Annual Report of the VIZE 97 Foundation and onto the www.vize.cz or www.prazskakrizovatka.cz websites (provided that this option was checked in the form).