Register

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*

IBAN*

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

Pronouns*
he/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
€10 deal (Only valid during the UIT)Discount deal (Only valid during the UIT)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
Everywhere. 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. For example, in a part of the website only accessible for members.Nowhere

I agree with the fact that SIB stores my data and that 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, the amount of which is stipulated in the Huishoudelijk Reglement (rules of procedure), from my bank account.