Snellius membership form
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First Name *
Last Name *
Birthday *
MM
/
DD
/
YYYY
TUDelft email adress *
Which ends on @student.tudelft.nl in case you are a student
Personal email adress *
We may want to contact you some time long after your tudelft email adress expires!
Repeat personal email adress *
Phone number *
Mobile number you currently use
Home address: Street and number *
Home address: Zip code *
Home address: City *
Nationality *
Are you a student or PHD? *
Background *
What and where did you study? Study/University/Country
In case of PhD: What is your PhD about?
Just out of interest!
I agree to pay the mandatory membership fee.
Students: 15 Euro         PHD: 35 Euro
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