Inscription form for the extraordinary General Assembly of Assitej Belgium

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Live at de Winkelhaak (Lange Winkelhaakstraat 26, 2060 Antwerpen ) or online on September 8th at 10.30am
Welcome for a coffee/tea first at Zonzo Compagnie: Offerandestraat 1-3, 2060 Antwerpen from 9.30 am on.

Email *

Name *

First Name *

I'm an *

individual member

organization

Name of the organization

I will join the extra-ordinary Assembly *

Live

Online

I won't be able to join, but I give a proxy (please answer the next question)

I'm not able to join and don't give a proxy, but want to become board member (fill in the fields below)

Person I'm giving the proxy to

Please make sure this person only has one proxy

We are still looking for new board members!

If you want to become a new board member, fill in the fields below before the general assembly

Motivation to become member of the board (1000 characters max.)

What do you think your expertise/experience could bring to Assitej Belgium (1000 characters max.)

A copy of your responses will be emailed to the address you provided.

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