I am a friend of the MSS Research Foundation. I authorise the MSS Research Foundation to send recurrent collection instructions to my bank to debit my account and my bank to debit my account on a recurrent basis. The amount is:

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You will receive a confirmation mail.

As parts of your rights, you are entitled to a refund from your bank under the terms and conditions of your agreement with your bank. A refund must be claimed within 8 weeks starting from the date on which your account was debited. Ask your bank for the conditions.

Thank you for your support!

MSS (Marshall-Smith Syndrome) Research Foundation | Oeverbiesstraat 20 | 2548 WP The Hague | The Netherlands | www.marshallsmith.org | info@marshallsmith.org | Registered KvK 27309021 | RABOBANK NL83 RABO 0140 3511 59

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