Member registration - UNICollaboration

Membership registration and payment

Membership payment credit card or bank transfer

Name(Required)

First name

Last name

Email(Required)

Institution name(Required)

Address(Required)

Street Address

Address Line 2

City

County / State / Region

ZIP / Postal Code

Country

Product Name(Required)

Individual members – €40 per year

Student members – €25 per year

Institutional members – €140 per year

Commercial members – €200 per year

Extra institutional members

First name

Last name

E-mail

For an Institutional Membership you may register additional members.

Membership id

Invoice ID

Total cost

Payment method(Required)

Credit Card

Bank Transfer

Credit Card

Card Details

Cardholder Name