ClubCollect

Title

First Name (required)

Infix

Last Name (required)

Date of Birth

Nationality

Contact Email (required)

Billing Email (required)

Phone 1

Country Code (required)

Phone Number

Payment Type

Automatische incasso

IBAN (required)

I am the bank account holder or custodian.
By signing this mandate form, you authorise (A) ClubCollect to send instructions to your bank to debit your account and (B) your bank to debit your account in accordance with the instructions from ClubCollect. As part of your rights, you are entitled to a refund from your bank under the terms and conditions of your agreement with your bank. A refund must be claimed within 8 weeks starting from the date on which your account was debited.

CS Ubuntu Membership fee €15,00 (required)

Study

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Do you want to join a CS Ubuntu committee?

Additional Info