Subscriptions for category A shares – Cooperators/Workers

Contact details

First Name *Your first name

Last Name *Your last name

Date of birth *

You must be over 16 years old to become a Pedalo cooperator

Phone numberThis field is optional but can be useful if we need to contact you. It will not be used for commercial purposes and will not be shared.

Email *Your email address

Street *

box, apt

Municipality *

Postal Code *

Subscription

Name of your sponsor (if applicable)

Number of category A shares *“4“ is the number of shares recommended to ensure the sustainability of the project. For even more lasting support, you have the option of taking more than 4 share. As a mean of being a project open to everyone, it is also possible become a cooperator with less, please contact us at info@lepedalo.be

Total payable amount

EUR

Statutes of the cooperative Le Pedalo S.C. *I accept the statutes of the cooperative

I would like to benefit from the Tax Shelter *YesNoYou will receive a certificate each year with the amount that makes you elligible for a tax reduction when you file your taxes ( Box X, II in your tax return)

Payment

Please wire the amount indicated directly on our account BE65 1431 1374 1796 with your name and surname in the communication box .