APPLICATION FOR MEMBERSHIP EUROPEAN BRANCH 2016

Requestfornew membership
Renewal of my membership (please fill in First Name, Last Name and Membership-No. and update your detailsonly if necessary because of changes)
please fill in your answers (not handwritten please) and send this document with your signature by d

1.IDENTIFICATION

Name / :
First name / :
Homeaddress / :
Country / :
Tel home / :
Member-number / Yes, my number is IN-……..-EU
No, please create number
Profession / :
Employer/Company / :
Address / :
:
Country / :
E-mail address / :
Tel office / :
Tel portable / :

2.PAYMENT MEMBERSHIP FEE 50 EURO

by international bank money transfer on account IBAN BE43 310-1909360-01, SWIFT BBRUBEBB, IAATI-EB, ivzw, Bergstraat 50, 9820 Merelbeke, Belgium
by credit card Visa or Mastercard
Number :
Expirydate :…….. /201..
Cardholder :
Exceptional: by pay pal: use the bank address mentioned in this form. Treasurer: F. Dedeurwaerder and send a proof of your payment together with the application form

3.DECLARATION & SIGNATURE

I want to receive my postage at at my private address / business address
I accept the constitution, the code of ethics and by-laws of the Association (see
I accept that IAATI- European Branch puts my name on the membership list on the website (members only section)
If I attend an IAATI-seminar, I accept that my name & contact-info is mentioned on the attendees list available for the participants
I wish to receive messages from IAATI-E.B. by e-mail or by other means of correspondence.
Subscriptions are for one year from 1th January to 31th December.
I accept the processing of personal data in accordance with the choices I made in this form and the privacy statement below.
SIGNATURE….……………………………
DATE …………......

4.ONLY IN CASE OF NEW MEMBERSHIP

Your application has to be approved by one IAATI Member and one IAATI Boardmember.
Do not return without their signatures (see next page)
IAATI EB Member
Name:
Membership ID:
Signature:
Date: / IAATI EB Board Member
Name:
Membership ID:
Signature:
Date:

Membership Form Privacy Statement

Your personal data is being processed by I.A.A.T.I.-E.B., an international nonprofit association incorporated under the laws of Belgium, with registered offices at B-9820 Merelbeke(Belgium), Bergstraat 50, company number 0894.251.908 (Register of Legal Entities of Ghent, Belgium).

All fields in this form are compulsory. I.A.A.T.I.-E.B. cannot process your membership application or renewal in case of incomplete forms.

The personal data collected by means of this form shall be processed solely for the following purposes:

-Membership management (including, if accepted, the publication of a membership list);

-Internal record keeping;

-I.A.A.T.I.-E.B. related communication and research;

-Website research purposes;

-Market research purposes.

You have a right, free of charge, to access and rectify personal data relating to you and you may object to the processing of your personal data for direct marketing purposes. Please review our privacy policy for additional information on exercising these rights.

I.A.A.T.I.-E.B. will communicate the personal data collected through this form to IAATI International for membership management purposes. You accept the communication of your personal data to IAATI International, even though it may be established in a country that does not offer adequate protection. The processing of your membership is not possible without this transfer of personal data.

Statement regarding e-commerce

Given the procedure of the application, I.A.A.T.I.-E.B. and the applicant agree not to apply the articles XII.7, §1 (information on the ordering process), XII.8 (technical means for error correction) and XII.9 (confirmation procedure) of the Belgian Code of Economic Law.

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