Cancellation of membership – Swiss HePa

Cancellation of membership

Cancellation of membership *

I hereby confirm that I wish to cancel my membership of the Swiss Liver Patients Association Swiss HePa.

We need the following information so that we can accept your cancellation correctly...

Member as... *

Individual
Legal entity (company, organisation, association) – without voting rights

Salutation / Title

Name *

First

Last

Address *

Street, house number

Additional Address

Address addition

ZIP *

Postcode

City *

City

of Privacy membership

Telephone (landline) *

Telephone (mobile)

E-mail *

Email

Confirm Email

Remarks

Human or bot? *

=