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First Name*

Last name*

E-mail address*

Postal code*

City/place*

Street*

House number*

Do you want to receive digital or physical mail?*
DigitalPhysical

Mobile phone number*

Educational institution*:
Hogeschool UtrechtUtrecht UniversityOther:
Study (optional)

IBAN*

Date of birth*
(dd-mm-yyyy, for example 27-04-2006)

Pronouns
(blank) / prefer not to specifyhe/himshe/herthey/themOther:

Do you speak Dutch?*
YesNoSomewhat

In case of an emergency:
Name*

Phone number*

How did you learn about SIB?

Do you have any allergies/dietary preferences?

Do you have any medical conditions that we need to know about?
(of course this information will be confidential)

Comments

Membership deal*
No deal

If the membership deal is not valid at the moment of registration, we will assume 'no deal'.

I give SIB permission to use visual and audio material in which I occur identifiably*
For both internal and external promotion and communication. For example: the promotion committee wants to post a nice picture on social media. Is this allowed if you are on the photo?Only internally. Like in the magazine for members and alumni, or a photo page on the website only accessible to members.Nowhere You can change your permission at any moment by sending us an e-mail requesting this.

I agree with receiving a weekly e-mail with updates from the association and information about activities. (Unsubscribe at any time)

I agree with how SIB stores en processes my data and I know I have the right to request my own data and to have it removed at all times.
I hereby authorise SIB-Utrecht to collect the recurrent yearly contribution from my bank account. The contribution is stated on this page, and may change for subsequent years, as prescribed by the statutes.
I agree with SIB's code of conduct (see bottom of page).