VLIZ

Flanders Marine Institute

Platform for marine research

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Membership online registration form

You can submit your VLIZ membership application online by filling in the form below. You can make the payment by bank transfer or by online payment.

Title *

Last Name *

First Name *

E-mail *

Telephone number

Applies for VLIZ membership as: *

Student, incl. PhD students [10,00 €]

Individual Member [30,00 €]

Individual Member + Partner [40,00 €]

Institutional Member [100,00 €]

Full name partner

Function

Affiliation

Please send all VLIZ correspondence to: *

professioneel adres

privé-adres

Professional address

VAT number

Street and number

Postal code

City

Country

Private address

Street and number

Postal code

City

Country

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