Become a member of inbitween

Your name and student number

Initials

First name

Surname

Student number

Ways to contact you

Email address

Secondary email address (not required)

Street

House number

Postal code

City

Mobile phone number

Fixed line number (not required)

More about yourself

Date of birth

Sex
 male female other

Financial data

IBAN

BIC number

Name of account holder

I authorize inbitween to debit member fees from your bank account on a recurrent basis.

Finish your membership request