Velden met een * zijn verplicht.Membership categorycategory *Instituut I lidmaatschap (3 passen)Instituut II lidmaatschap (4 passen)Instituut III lidmaatschap (5 passen)Instituut IV lidmaatschap (6 passen)Instituut V lidmaatschap (7 passen)Instituut VI lidmaatschap (8 passen)Supportive Institutional Membership (8 passen)Contact dataName institution *Department / attn. to Street *Number *Number suffix Postal, areal code *City *Country Telephone number Contact email address (used for communication) *Email 2 (i.e. work or private) Preferred language of communication *DutchEnglishContact personSalutation *manvrouwFirst name (informal) *Initials Infix Last name Representatives Name Representative 1 Preferred International Committee Name Representative 2 Preferred International Committee Name Representative 3 Preferred International Committee Mail addressPost office box Number Postal, areal code City Country Banking dataIBAN (IBAN bankaccount) BIC / SWIFT Name account holder E-mail address for incoming invoices OtherNon-museums are required to upload a brief motivation in which they elaborate on the added value of membership for both ICOM and applicant. Check MarksI adhere to ICOM’s Ethical Code *We accept automatic withdrawal of our membership fee by ICOM We agree to processing and usage of our data in accordance with GPRS rules *Bevestiging geen robotOp dit formulier is een beveiliging actief. Los de som op om verder te gaan, en gebruik cijfers in het antwoord.