1. 2018 – HEALTHY HABITS CAMPAIGN
APPLICATION FORM – choose from among the 4 options listed below (mark with X)
OPTION 1
OPTION 2
OPTION 3
OPTION 4
Activity tracker
Bicycle helmet
Bathroom scale
Blood pressure monitor
APPLICANT DATA (please use capital letters and numbers easy to read )
Name
Address
Birth date
Bank name
Bank account: SWIFT/BIC code
Bank account:
IBAN number
Your company
Employment date
Declaration of Consent
To be filed together with this application
In some countries, there might be unavoidable expenses that the Employee Foundation cannot cover on behalf of our employees, e.g. bank fees and tax. This means that the final amount paid out might be less than EUR 50.