Last Name: First Name: E-mail: Date of Birth: Street and Number: Postal Code and City: Employment status: ZAP - having tenure ZAP - temporary Assistant Doctor-assistant Praktijkassistant Predoctoral researcher with scholarship (bursaal) Scientific staff (WP) Teaching staff (integratiekader) other: Employment contract: full time part time:% retired unemployed other: Faculty: Department: Office address: Start date membership: Bank account number: Name of the bank: Remarks: Please note: after you have submitted this form clicking the button below, you will receive some formal paper documents at your home address. You need to fill in and sign these documents, and send them back to the address mentioned on them. After this your membership will be fully registered.
