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In order to donate on-line ones, they must enter the following data those with * marked are complete. 
       
          

          
 
            
 
 Personal data

          

          
 
             

          
 
 Adress  

          
 
             
            Name*
               
          

          
 
             
            Surname*
                
          

          
 
             
            Road / Nr.*
             
             
          

          
 
             
            Postalcode / Village*
            
	  
          

          
 
             
            Country
               
          

          
 
             E-Mail 

          

          
          
 
            
 
 Data to the donation height

          

          
 
             

          

          
 
            
     
    
          

          
 
            

          

          
 
            

                
 
                  
Examine your inputs again for correctness

                

              

              
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