1
Company Details
2
Contacts
3
Courier contacts
4
Bank details
5
Valoarea contractului
Adress *
Postal Code *
County *
City *
Adress
Postal Code
County
City
1
Company Details
2
Contacts
3
Courier contacts
4
Bank details
5
Valoarea contractului
Legal Representative
This information will appear in the contract.
Title *
First Name *
Last Name *
Email *
Phone *
Position within the company *
Other contacts
From here you can add all the people who want to receive information from us.
1
Company Details
2
Contacts
3
Courier contacts
4
Bank details
5
Valoarea contractului
Correspondence Officer
Choose which of the added people you would like to be contacted by the courier for the delivery of the contract, in physical format.
1
Company Details
2
Contacts
3
Courier contacts
4
Bank details
5
Valoarea contractului
Bank data
The data entered will be used both in the contract and to identify payments in our platform.
IBAN account *
Open the bank *
1
Company Details
2
Contacts
3
Courier contacts
4
Bank details
5
Valoarea contractului
Fill in the date and amount
In order for the process to proceed faster and to take possession of the signed contract directly, please fill in both fields below.
Date of contract *
Contract amount *

RON

However, you can press the button below even if you are not yet determined by the amount you want to donate. This detail can be completed later.
The donated amount will be distributed to the #NoiFacemUnSpital project: The First National Children's Hospital for Cancer, Serious Illness and Trauma.

Abandon the contract

Are you sure you want to cancel the sponsorship form?

No
Yes