Membership fees
Note: Annual membership runs from 1 January till 31 December
Clinician & Reproductive biologist : 75 Euro (incl. 21% VAT)
Paramedical, Resident in training, Students (Master, PhD, post-doc..) : 40 Euro (incl. 21% VAT)
Member information
First Name
*
Last Name
*
Title
*
Prof. Dr.
Dr.
Ms.
Mr.
Institute
Street - number
*
Zip Code
*
City
*
Country
Vat Number
Email
*
Date of birth
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2
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10
11
12
13
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17
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19
20
21
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25
26
27
28
29
30
31
Day
January
February
March
April
May
June
July
August
September
October
November
December
Month
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
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1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Language
Dutch
French
English
Other
RIZIV number
Format 1-12345-12-340
Invoice address
invoice address is different from the information provided above
Invoice Company
Invoice Department
Invoice Street & Number
Invoice Zip Code & City
Invoice Country
Invoice VAT Number
Invoice Remarks
Membership category
*
Clinician (75 Euro)
Reproductive biologist (75 Euro)
Lab technician (40 Euro)
Midwife (40 Euro)
Nurse (40 Euro)
Resident in training, Students (Master, PhD, post-doc..) (40 Euro)
Other (75 Euro)
Payment method:
*
Bank transfer
Visa / Mastercard
Calculation
Total
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EUR
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Payment policy
Full payment has to be made to the BSRM account with reference: “Name + membership”.
IBAN number: BE79 3101 2631 7833, BIC: BBRUBEBB, Bank: ING.
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