Apply to DV!

Thank you for being interested in our association! Please give the form some seconds to load and fill it in accordingly.
The annual contribution is 5 euros, which will be deducted directly from your account.

Apply to Dispuut Verkeer!

* Indicates required field

Name *

First

Last

Address *

Postal/ Zip code *

Country *

Gender *

Female Male

Phone Number *

Email *

Date of Birth (dd/mm/yyyy) *

IBAN *

Student Number *

Type of Membership *

Student T&P Student TIL Alumni Member Staff & Phd member

Comment *

I herewith authorize dispuut Verkeer to withdraw the yearly contribution from my bank account until I terminate my membership, along with any other costs for activities I sign up for *

I agree

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