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Application Form

PERSONAL DATA COLLECTION
The personal data provided by you will be used for BHKS-related purposes only and may be shared with third parties for relevant purposes.

Application form

CORPORATE MEMBERSHIP(?)
INDIVIDUAL MEMBERSHIP(?)
YOUNG/RETIREE MEMBERSHIP(?)


Title*
 Title*
Last name*
 Last name*
First name*
 First name*
Position
 Position
Address (Street and Number)*
 Address (Street and Number)*
Zip code and City*
 Zip code and City*
Country*
 Country*
Telephone (1)*
 Telephone (1)*
Telephone (2) Telephone (2)
Fax Fax
E-mail*
 E-mail*

Membership Fees

Depending if you are Individual Menber (EUR 100 a year)
or Corporate Member (EUR 300 a year) or Young/Retiree Member (EUR 50 a year)

Payment by bank transfer :
Please transfer the amount to the Society’s :
ING Account N° 310-0714657-47
IBAN : BE22 3100 7146 5747
Swift : BBRUBEBB

Anti-spam *
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