Business Club registration form

Billing form

Company Name*

Attn:*

Function

Address*

Phone, mobile*

Telephone, business

E-mail address*

Ascription playing right 1

Start time reservation by (Silver, Gold, Diamond)

Name*

Date of birth*

GSN Number

Stands on NGF pass and begins with NL

E-mail address*

For reservations, the app and communication

Phone*

Membership fee 2

Start time reservation by (Silver, Gold, Diamond)

Name*

Date of birth*

GSN Number

Stands on NGF pass and begins with NL

E-mail address*

For reservations, the app and communication

Phone*

Comments

Collector

Name :	Tespelduyn Estate & Golf Course B.V.
Address :	Tespellaan 53
Zip Code :	2211 VT
Residence :	Noordwijkerhout
Country :	Netherlands
Collector ID :	NL08ZZZ273576170000
Authorization reference :	* will be filled in by Tespelduyn

By signing this authorization form you give permission to Landgoed & Golfbaan Tespelduyn B.V. to send continuous direct debit orders to your bank to debit an amount from your account for:
(annual) contributions.

and to your bank to continuously debit amounts from your account in accordance with the instructions of Landgoed & Golfbaan Tespelduyn B.V.

If you do not agree with this debit you can have it reversed.

Please contact your bank within 8 weeks after the debit. Ask your bank for the conditions.

Debtor

Name*

Address*

Same as billing address

Account number-IBAN*

Place & date:*

Name*

Signature*

Payment method

Subscription form (Business Club Tespelduyn)

Extra opportunities & Exposure

Billing form

Ascription playing right 1

Membership fee 2

Collector

Debtor