Registration Form E.S.K.V. Attila
Eindhoven Student Korfball Association Attila
Full Name
*
First Name
Last Name
Gender
*
Please Select
Male
Female
Prefer not to say
Date of Birth
*
-
Day
-
Month
Year
Date
Contact Number
*
-
Country Code
Phone Number
Email Address
*
Preferably a gmail account
Address
*
Street + Number
Street Address Line 2
City
Postal / Zip Code
Study institution
Sports card number (SSC)
You can find this on your personal account at ssceindhoven.tue.nl
Membership
*
Please Select
Training Member
Active Attilian
Midweek member
Weekend competition member
Yearly contribution: Weekend competition member €99,-; Midweek member: €70,-; Active Attilian: €35,-; Training member: €20,-. All amounts are subject to change.
I register for the year
blanks
*
/
blank
*
.
I agree with the privacy policy of E.S.K.V. Attila
*
Yes
No
I agree that my membership will be tacitly continued every year
*
Yes
No
Signature
*
Place, date
Continue
Continue
Should be Empty: