Membership NSVV FC Kunde

First name: *

Last name: *

Date of birth: *

Gender: *

Male
Female

Current adress: *

Zip code and city: *

Phone number: *

e-mail adress: *

Student number:

Study institution:

HAN
RU

As a selection member you must have subscribed before June 10th, otherwise it is not possible to join the selection training sessions.

You will be granted a priority on the waiting list. If you do not make the selection teams, you will be placed back on the waiting list.

I want to become a: *

Competition member (preference selection)
Competition member (preference recreative)
Training member once a week
Training member twice a week
Activities member

Are you a goalkeeper? *

Yes
No

I have played competition before:

Yes
No

If yes, at what level (division)? Youth or seniors?

If you had a subscription to another club in the last three years

At which club was this?

A distinguishment is made between men and women. Answering "Yes" to this question gives no direct guarantee.

Are you willing to act as a referee in some games to obtain a higher place on the waiting list?

Yes
No

I declare to have read the privacy statement and by answering "yes" I accept the terms. (See on top of page). *

Yes
No

Other remarks:

Vul in: 1924

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