ESFR Registration and Feedback Form for Associate Institutional Membership

My organization is interested in supporting the ESFR and becoming an associate institutional
member. We will transfer our payment of 900 EURO for the first year and 600 EURO for
the following years to be transferred to the temporary bank account of the ESFR until one
week after registration.

ABN-AMRO Bank Nijmegen
Account Number: 54 11 01 935
Name of the holder: European Society on Family Relations
BIC Code: ABNANL2A IBAN: NL34ABNA0541101935

Institution/Organization/Firm*:
Representative*:Mr.Mrs.
Last Name*:
First Name*:
Affiliation of Representative:
Discipline /e.g., Psychology, Sociology, etc.):
Street*:
City*:
Postal code*:
Country*:
Phone:
Fax:
email:
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