Membership for universities and colleges

Username

Repeat email

Password

Repeat password

I wish to subscribe for the following KVCV membership (1 year duration):

Membership

Membership for universities and colleges: € 363

This amount includes 21% VAT.

Contact person

Title

First name

Last name

Professional data

Function

Affiliation (company, institute)

Affiliation department

Address

Postal code

City

Country

Tel

Invoice data
Use the same data than above

Affiliation (optional)

Name

Department (optional)

Address

Postal code

City

Country

VAT number

Invoice

I want to receive an invoice from KVCV

My institution will send an order first

If you choose to send an order first, please address this to :
KVCV vzw attn An Mammolito, p/a Universiteit Antwerpen, Campus Groenenborger, Departement Chemie, Groenenborgerlaan 171, 2020 Antwerpen
Or by email to info@kvcv.be

Reception of membership card and C2W | Mens & Molecule

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Membership for universities and colleges

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