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info@aelip.org Call us: +34 692 397 840

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What is AELIP? > How can we collaborate with the AELIP Association

How can we collaborate with the AELIP Association

OUR OBJECTIVES

- Inform patients, families and professionals of the resources that exist in the field of lipodystrophies, creating information and coordination networks.
- Promote RESEARCH actions in the field of lipodystrophies.
- Carry out actions to raise funds, promoting awards calls, scholarships and work that enable the development of research projects.

Objetivos

I WANT TO BECOME A MEMBER DOMICILING MY FEE:

Name and surname *

Address

Location *

Province *

Postal Code *

NIF *

Phone *

email *

Birthdate

My fee will be:	Periodicity:
30 €	Monthly	Biannual
60 €	Monthly	Biannual	Annual
Another amount	Monthly	Quarterly	Biannual	Annual

I WANT TO COLLABORATE WITH AN ECONOMIC CONTRIBUTION

Amount

Data for direct debit:

Account holder

Name of the Fund or Bank:

N° c/c:

In the different banking entities:

LA CAIXA - c/c n° ES40 2100 2759 2302 0010 1469

We guarantee that the information you provide is confidential, for the exclusive use of the AELIP Association and rectify it whenever you wish.

SPONSORING RESEARCH PROJECT IN LIPODISTROFIAS

12 euros per year

Another amount per year

The contributions made to sponsor a research project will have a minimum duration of 1 year, and may be renewed if there is agreement between the two parties. The charges will be charged to your account on a annually basis.

Introduce this code:1942024 *

Comments *

By submitting this form you agree to become a member of AELIP under the conditions indicated therein

* Required fields

The owner of the personal data, collected in this form, expressly authorizes Association AELIP to treat these data in a computerized way and be able to incorporate them into their database. The user may exercise the rights of access, rectification, cancellation and opposition of their personal data, under the terms established by the LOPD, at the address set in calle san cristobal nº7 Totana (Murcia) España . For your convenience you can exercise the rights also by email at the address info@aelip.org

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