Alborz Association Membership

Alborz Association Membership

Please fill out the form to become a member of the Alborz association
Using this form you can register for D.I.S.A. Alborz membership on the condition that you are affiliated with a university in the Netherlands.

Becoming a member gives you perks, such as discount on paid activities, access to certain activities and the chat group of members.

Non-members are welcome to participate in activities open to all, but not those exclusive to members.
Name*

First NameLast Name
Birth Date*

MonthDayYear
Sex
E-mail*
example@gmail.com
Phone Number*
Nationality*
What is your position in the academic field?*
Which university are you affiliated with? *
Any other remarks and/or questions that you would like to share with us?
Would you like to be added to the Telegram group of Alborz?
Telegram Phone Number

Country CodePhone Number
Should be Empty: