Barrierefreie Bedienung der Webseite

REGISTER AS AN INDIVIDUAL

* First name
* Last name
First name of partner for couple membership only
Last name of partner for couple membership only
* Street
* ZIP code, City
* Phone
* Email
* Date of birth
Date of birth of partner for couple membership only
* Address for donation confirmation (Street, ZIP, City)
* Contribution
- Yes, I want to support the Leopold Museum with a contribution of EUR 300,00 for a one-year membership in SALON LEOPOLD.
- Yes, we want to support the Leopold Museum with a contribution of EUR 500,00 for a one-year couple membership in SALON LEOPOLD.
* Approval
- I consent that the personal data (name, e-mail address) given in this form may be electronically processed by the Leopold Museum Private Foundation, Museumsplatz 1, 1070 Vienna, for the purpose of sending up-to-date information, and that this information may be sent to me by mail or e-mail. I am aware that my personal data will be stored for the duration of a statutory retention period. Furthermore, I am aware that I may revoke this consent at any time, for future effect at any time, in whole or in part. Theprivacy policy of the Leopold Museum Private Foundation can be accessed at any time.

Bitte dieses Feld leer lassen