Single Associate registration form

Become a member:
Single Associate Membership registration form

By completing and submitting this form, you will become part of the largest group of CIOs and digital technology leaders in Belgium. Your Beltug Single Associate Membership is limited to organisations with fewer than 200 employees.

1 Company

Company information

all fields indicated with an * are mandatory

enter N.A. if not applicable

Organisation Name

Street & Nr

Building, floor, department

ZIP

City

Country

Company phone (enter N.A. if not applicable)

Company email

Your email (for follow-up and confirmation purposes)

VAT number (enter N.A. if not applicable)

Website (enter N.A. if not applicable)

Billing information

Please fill in your address only when it's different from the address provided in the previous step.

Organisation Name

Street & Nr

Building, floor, department

ZIP

City

Country

Email for invoices

Your order number to facilitate payment procedures:

Other information

Sector

Member 1

M FX

First name

Last name

Job title

Tel

Mobile

Language

NLFREN

If other, please specify:

Remarks

0 /

We wish to join Beltug vzw/asbl. Our membership is valid until 1 January 2024:

Single Associate Membership: € 950,00 per year (excl. VAT)

Hit 'submit' to confirm your subscription. You will receive an email confirmation and the invoice upon receipt of this form.

Your membership will be automatically renewed at the end of its period, unless we receive a written cancellation from your organisation.

Many thanks for joining Beltug. 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. Read our Privacy Policy for more information.

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Become a member: Single Associate Membership registration form

Become a member:
Single Associate Membership registration form