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Unlimited Membership Registration Form


The undersigned organisation wishes to become an unlimited BELTUG member

Company information

(all fields indicated with an * are mandatory)
 



Your Order Nr to facilitatie payment procedures (enter N.A. if not applicable) *: 
How I got to know BELTUG (via?) *: 

Member 1:


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Last & First Name : 
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E-mail : 

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If other, please specify : 

Member 2:


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Member 3:


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Member 4:


Title :     

Last & First name : 
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Member 5:


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Remarks:


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I wish to adhere to BELTUG vzw/asbl. Our membership will be valid until January 1st 2013:

Unlimited Membership (5 people or more from your company enjoy the advantages of a membership - this formula applies to companies and public services using ICT only!) : € 975 (ex VAT)

Click "submit" to transmit your affiliation per e-mail or send to:

BELTUG vzw/asbl
Attn Ms A. De Ridder, Knaptandstraat 123 at 9100 Sint Niklaas (Fax 03 766 41 86).
A written confirmation and an invoice will be send to you upon receipt of this form.

Thank you for registering.

BELTUG respects your privacy. All personal data that you provide, whether via our website, forms or e-mail, will be treated with the highest confidentiality, and used only to keep you informed of our activities. In order for you to benefit from your free subscription to DataNews (value 50€), included in our membership, your postal address and name will be provided to Roularta Media Group; our contractual agreement with Roularta Media Group allows them to use your contact information for this purpose alone. Click info@beltug.be if you do not want us to provide your contact details to Roularta Media Group.

According to the Act of 8 December 1992 on privacy protection, you have the right to consult your data at any time, and to change it or delete it if you do not want to receive any further information about our activities.

Our contact details are: BELTUG, Knaptandstraat 123, 9100 Sint Niklaas, Tel 03 778 17 83 or email: info@beltug.be

 
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