ESFR Registration and Feedback Form for Student Membership

I am interested in supporting the ESFR and I want to become a student member.I will transfer
my payment of 25 EURO for the first year of my membership to the temporary bank account
of the ESFR

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

Please select*:Mr.Mrs.
Last Name*:
First Name*:
Title:
Affiliation:
Discipline (e.g., Psychology, Sociology etc):
Mailing address*:private addressinstitutional address
Street*:
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Postal code*:
Country*:
Phone:
Fax:
email:
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