Design for All Foundation International Networks

MEMBERSHIP APPLICATION: INDIVIDUAL

  1. Please provide contact details for the person completing this form:

First name and surname
Tax identification number (if applicable)
Street address
City or Town / Postal/ZIP code
State/Province
Country
Telephone / Fax
Email
  1. Please select the international networks in which you would like to be active and/or about which you would like to receive information from the list below:

Towns and Cities for All
User-Centred Business
Museum for All
Society for All
  1. Please indicate the annual membership fee payable by you for the current year by placing an “X” in the appropriate box:

NATIONAL HDI (HUMAN DEVELOPMENT INDEX)
VERY HIGH
(1 - 0,78) / HIGH-MEDIUM
(0,77 - 0,48) / LOW
(0,47 – 0)
INDIVIDUAL(PRIVATE) / 50 € / 40 € / 30 €
I would like to make now an additional donation of€

Date: Signature:

The annual fee (*), as stated at point 3 or additional donationshould be made via:

  • Credit card
  • Bank transfer

Bank: Banco de Sabadell, S.A.

Address: Consell de Cent, 21, 08014 Barcelona

Account holder: Design for All Foundation

Bank account: (IBAN) ES04 0081 0110 6100 0120 5825

BIC/SWIFT: BSABESBB

When making the transfer, please include the register number together with your name.

Please send your completed form and the evidence of payment to: or by fax: +34 933717649

After receiving your application our Foundation will contact you to welcome to the networks. Please note that your membership cannot be confirmed until we have received the Membership Fee. By way of this payment, the applicant accepts the Membership terms and conditions set out in this document. Pleasenote thatthe Foundation reservesthe right to denyits membershipif it findsevidence ofillegal activityon his part.

To renew membership, fees should be paid every year within seven days of the date of the first payment. In the event of a fee alteration, members will be notified three months in advance.

Any member of the networks can be expelled if there is evidence of involvement in actions against human rights and diversity, according to the criteria of the Design for All Foundation Board.

(*)The amount transferred for the membership of the Network should be considered a membership fee of an international organization; it does not constitute a rendering of professional services as defined in the 25th article of the Spanish Law 49/2002.

*In compliance with the established Organic Law 15/1999, December 13th, on the Protection of personal data, we remind you, through the completion of this form, that your personal details will be incorporated and filed in the Design for All Foundation, for the purpose of offering you our services and to be informed of the initiatives and news updates in the field of Design for All. Therefore, you are notified of the possibility to exercise your rights regarding access, rectification, cancellation and opposition of your personal data. You may contact the Foundation at or at Carrer Piquer, 29, Baixos 1, 08004-Barcelona, Spain.

1

Design for All Foundation: Carrer Piquer, 29, Baixos 1ª (08004-Barcelona, Spain)

Tel: +34 934705118 / Fax: +34 933717649 /