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Naam
*
Voornaam
Achternaam
Date of birth
*
DD/MM/YYYY
Address
*
Street name + number
Postal code
*
City
*
Country
*
Phone number
*
land code: please use 00 instead of '+' e.g. the Netherlands will be 0031 (Not +31)
E-mail
*
E-mail
E-mailadres bevestigen
IBAN/ Bank account number
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Are you a student at the UU or HU?
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Yes
No
Type of membership
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Full membership (practice + games)
Practice only
Game days only
Donation
By checking the box below you agree to pay the membership fees
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I agree
By checking the box below you agree that you've filled in the SEPA authorisation
I agree
https://www.domstaddevils.nl/sepa-formulier/ Please e-mail to; secretary@domstaddevils.nl
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