Individual Membership Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

ELACTA moved to an online form of collecting the necessary information and data to regulate membership in the ELACTA.

This form is the AGREEMENT between ELACTA and Indivudual Member  to perform mutual obligations during the period of the agreement.

ELACTA Membership forms are set out in clause 4 of the ELACTA Statutes. This Membership Form  is for membership of INDIVIDUALS who have no professional associations in their countries, or their country association is not a member of ELACTA. If there is and ELACTA Memeber Association in your country, please apply for ELACTA membership through it.  
After filling in the data, you will receive a pro forma invoice for the payment of the membership fee. 
Please fill out this form no later than March 15 of the current year., and you  will receive a pro forma invoice for the payment of the membership fee.

As a member of ELACTA you are a part of growing network of IBCLC’s in Europe!

Date of filling *

YYYY

First name *

Last name *

Are you IBCLC *

Yes

IBCLC number (if you are not an IBCLC write NO) *

Postal Address *

Zip Code *

City *

Country *

Email *

Are you a member of an association of IBCLCs in your or other country ? *

Yes

If yes, which?

Usually individual members are from the countries where there is no national IBCLC's Associations and they receive ELACTA journal Lactation&Breastfeeding in pdf format online. If you wish in addition to receive the German version of the journal “Laktation & Stillen”, please fill in the next boxes.

I wish to get online-access to the English journal of ELACTA - “Lactation & Breastfeeding”
*

Yes

I wish to receive the German paper journal of ELACTA - “Laktation & Stillen”: € 29,-/year/4 issues *

Yes

I confirm that I have read and agreed to all the conditions and obligations of the membership to ELACTA, as found at the link: https://www.elacta.eu/individual-membership-application-bf/ *

I confirm

I accept the privacy policy. Finde more on: https://www.elacta.eu/deutsch-gdp *

I accept

Thank you for being with ELACTA and strengthening the network of IBCLCs in Europe.

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of ELACTA. Report Abuse

Forms