Listen Fill in the sign up form Fapiano Club Circle of Champions sign up formName *Lastname *Mobile number *Email *Date of birth Company name Write your company name if you would like to make the donation through your companyWhich of the following describes you? *I am already donating FL50,- or more per monthI will increase my donation to FL50,- or more per monthI will be donating for the first timeWould you like to make that donation monthly or one time? *Monthly (FL50,- or more per month )yearly (FL500,- or more per year)Write here the amount you will donate *Minimum amount for the Fapiano Club is FL50,-Choose your preferred bank *MCBRBCBdCIs there any remarks you want us to know? Do you agree to be a member of the Fapiano Club “Circle of Champions” with a monthly or yearly donation? *You will arrange your monthly or yearly payment with your bank.I Agree VerificationPlease enter any two digits *Example: 12This box is for spam protection - <strong>please leave it blank</strong>: