ClubCollect

Studiekring voor Plantenveredeling

Personal Details

Please enter as title: ir., dr, PhD etc. instead of for example mevrouw.

Organisation Name

Title

Initials

Infix

Last Name (required)

Gender

Male

Female

Rather not say

Contact Details

Please enter a mobile number.

Contact Email (required)

Phone 1

Country Code (required)

Phone Number

Phone 2

Country Code

Phone Number

Find Address

Type in some of your address details to locate your address

Address line 1

House No.

Extension

Postcode

City

Country

Payment Details

Payment Type

iDeal payment

Direct debet / incasso

How would you like to pay in the future?

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.

Other information

Type of Membership (Subscription/Plan) (required)

Would you like to receive email messages concerning the study group? (required)

Yearly we send you a couple of emails regarding the study group, invitations to our meetings mostly.

Second mail address

Please enter an alternative email address (private or business).

Study

What is your most recently completed course of study? For example, the field of study of your master's degree.

Graduation year

In which year did you complete your last study.

Additional Info

Is there anything you would like us to know?

I consent to the processing of my personal data by the Study Group for Plant Breeding and agree to ClubCollect's Privacy Statement.