Membership – Snellius Dispuut

Snellius membership form

*Obligatoriu

First Name *

Răspunsul dvs.

Last Name *

Răspunsul dvs.

Birthday *

AAAA

TUDelft email adress *

Răspunsul dvs.

Personal email adress *

We may want to contact you some time long after your tudelft email adress expires!

Răspunsul dvs.

Phone number *

Mobile number you currently use

Răspunsul dvs.

Home address: Street and number *

Răspunsul dvs.

Home address: Zip code *

Răspunsul dvs.

Nationality *

Răspunsul dvs.

Are you a student or PHD? *

Student

PHD

Background *

What and where did you study? Study/University/Country

Răspunsul dvs.

In case of PhD: What is your PhD about?

Just out of interest!

Răspunsul dvs.

I agree to pay the mandatory membership fee.

Students: 15 Euro PHD: 35 Euro

Yes I agree

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