IBN RUSHD e.V. Fund for Freedom of Thought

Yes, I want to sponsor the Ibn Rushd Fund

Please print this form, fill it out, and send it to the following address by mail or by Fax:
Ibn Rushd e.V.,  Wiesenstr.53, Schoenwalde,  Germany,  Fax: ++49- (0)33056 43 64 70


Name: ________________________ Title: ________________________


First Name: ________________________ Occupation
Street: _________________________________
City: ________________________ Zip Code: ________________________
Country: __________________________
Phone #: ________________________ Fax #: ________________________
E-Mail: __________________________________
Date of Birth (voluntary): __________________________________
I agree that my name will be shown on the IBN-RUSHD web site as a donor:  Yes_______


The recommended annual contribution is EUR 50,--
Date: ______________ Signature: ____________________________

If you wish to become an active member, please contact us.

Thank you for your support. You are thus making an important contribution to freedom and democracy in the Arab World. Sponsor donations can be transferred to:

Ibn Rushd regd., Bank Account # 704 128 600, Volksbank Brilon, Bank Code #41 661 719, Germany.