Bahçemiz 2009 Başvuru formu

Bahçemiz 2009 Project Application Form

Applicant:

Name Surname:

Address for the bill:

Post code :

Telephone:

E-mail :

Weekly delivery address :

Extra explanations for delivery:

Delivery choices:

  • Cost of for individual participant:  200+100+100+100+100 T.L. in monthly installments (Total 600,- (six hundred) Türkish Lira.

.Cost for group participants (name of group:…………………………………. ) where at least 5 boxes will be delivered to one address: 150+100+100+100+100 T.L. in monthly installments (Total 500,- (five hundred) Türkish Lira.

Payment:

  •  Payment to Guneskoy Cooperative account: 4229-0941380Türkiye İş Bankası ODTÜ Branch, for “Bahçemiz 2009”
  •  Credit card payment:

Card Type: __ VISA __ Master Card

Card number: __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

Valid until: __ __ / __ __

Security code (CVV): __ __ __

Start of Payment:  April 2009;  May 2009;  June 2009

 

Debit from Credit Card :

Please accept the payment from my credit card on 5th (or 20th) day of the months for the five installments.

I agree to participate in “Bahçemiz 2009” project according to the information given above. Türkiye İş Bankası A.Ş. and Güneşköy Cooperative administration are authorized to take the payment of the sum of the participation fee from my credit card.

Date, signature: