Membership Application Form

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

International Women in Business Düsseldorf e.V., Wittlaerer Kamp 13, 40489, Dusseldorf

If you have any questions regarding this application form or the application process, please email Melissa at membership@iwibdus.com

MEMBERSHIP FEE

The annual membership fee is currently €100 (January to December). For new members joining between September and December, the fee is reduced to €50 for that remaining portion of the year; however for the following year, the normal annual fee for the 12 month period will apply. Once you have submitted your application to join, we will contact you via email within the next 7 days.

Email *

PERSONAL DETAILS

Name *

Surname *

Preferred Name

If you have a preferred name that is different from your Name above, please provide that here.

Mailing Address in Germany (Street, Number etc) *

Postcode *

City *

Email Address *

Telephone Number *

Date of Birth (dd/mm/yy) *

YYYY

What is your nationality? If you have more than one, write the one you feel closer to. *

What is your first language? *

Which of the following statements applies to your situation: *

I am looking for a job

I want to create my own business / promote my existing business/organisation

I just want to belong to a professional network

Other:

How did you hear about International Women in Business Dusseldorf? *

Google

Came to an event via Eventbrite

Facebook

Instagram

Friend Recommendation

Other:

I was referred by the following member/friend:

DECLARATION AND CONSENT

I ask to join the International Women in Business Dusseldorf e.V and undertake to pay the annual membership fee. *

Yes

I declare that I have read the Statutes of the International Women in Business Dusseldorf e.V and accept these provisions (these are available on the website www.iwibdus.com/statutes) *

Yes

I understand that my membership is paid on an annual basis and is non-refundable I also understand that unless I give notice of my cancellation by the end of September, my membership will automatically renew and I will be obligated under German law to pay the annual membership fee for the following year.
*

Yes

I consent to the use of my personal data for the exclusive purposes of the International Women in Business Düsseldorf e.V. (These include the use of your photo and name in publications that will be used on our website and social media pages. We will also use your email as part of our mailing list.) *

Yes

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms