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