Liedtke Museum VIP Package Order All fields marked with (*) are required. Salutation* Please SelectMr.Mrs. Required field! Please choose your salutation! First name* Required field! Please enter your first name! Last name* Required field! Please enter your last name! Date of birth Day01020304050607080910111213141516171819202122232425262728293031 / Month010203040506070809101112 / Year190019011902190319041905190619071908190919101911191219131914191519161917191819191920192119221923192419251926192719281929193019311932193319341935193619371938193919401941194219431944194519461947194819491950195119521953195419551956195719581959196019611962196319641965196619671968196919701971197219731974197519761977197819791980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010201120122013 Entrada no válida Mobile phone (with country code) Required field! Please enter, if available, your fax number! Email* Required field! 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Please select your country! VIP package* Please selectSponsor package: 50 € + 10 Free sharesSponsor premium package: € 200 + 40 Free sharesVIP package: 400 € + 80 Free sharesPremium VIP package: 500 € + 100 Free sharesScience VIP package: 700 € + 140 Free sharesLounge VIP package: 800 € + 160 Free sharesBronze VIP package: € 1,000 + 200 Free sharesSilver VIP package: 1,500 € + 300 Free sharesGold VIP package: 2,500 € + 500 Free sharesPlatinum VIP package: € 5,000 + 1.000 Free shares Required field! Please choose your desired VIP package! Depot Culture Partner no. Required field! Please enter the depot cultural partner number, if available. Stock Company* I have read and accepted the information provided by the museum company "Código Universo Invest Holding SA". Required field! Please confirm that you have read and accepted the information from the company! Terms and Conditions* I have read and accepted the general terms and conditions (1 to 14) of the museum company "Código Universo Invest Holding SA". Required field! Please confirm that you have read the terms and conditions (1 to 14) and accepted! Attribution I would like to be mentioned on the Liedtke Museum website as a shareholder of the museum company "Código Universo Invest Holding SA". Required field! Please choose if you would like to be listed as a shareholder on the website of the Liedtke Museum. ------------------------------------------------------------------------------------------------------ Credit card I pay the invoice amount by bank transfer or with my credit card after receiving the invoice. Entrada no válida Credit card Please SelectVisaMasterCardAmericanExpressDiners Club Entrada no válida Credit card Nr. Entrada no válida Name on credit card Required field! Please enter your last name! Date Start Month/Year Entrada no válida Date Expiration Month/Year Entrada no válida ------------------------------------------------------------------------------------------------------ Data and Email address* The information must be completed as the registered shares cannot be entered in the Company's share register in the name of the holder with e-mail, telephone number and country and without this information and the entitlement to free shares expires without replacement. If the shares are sold or the e-mail address and telephone number are changed, this must be communicated immediately by e-mail, otherwise the shareholder cannot be invited to the shareholders' meeting. It has been agreed that the correspondence will be carried out legally by e-mail. The e-mail address provided is the legally valid delivery address. Required field! Please confirm that you have read and accepted the information from the company! I agree that* My personal data is collected in compliance with the GDPR for the dispatch of newsletters, advertising for ethical seminars, art events, works of art and ethical capital investments and hereby give consent to special ethical offers by electronic media to receive. The consent can be revoked at any time by simply clicking on the revocation button. Until I revoke my declaration of consent, I also agree that you may use cookies to help me find a better offer. Even if I reject the declaration of consent or revoke my declaration of consent to receive advertising on ethical offers at any time, I am still fully entitled to receive and retain the Gift Share. Required field! Please confirm that you have read and accepted the information from the company! Privacy policy * I accept the Privacy policy. Entrada no válida Capcha* Update Entrada no válida Order Reset
