Full data for each individual member, including updated private postal address and email address are required (only for internal use). Incomplete registration forms cannot be processed.
I would like to become a member of BSTH for 2019 / renew my membership *
Organisation / institute
We need to validate your mobile number for this event. We do this by sending you a code via SMS, which you fill in below.
My privat address is (only for internal use)
My profession is *
MD specialist, MSc specialist, PhD scientist
MD trainee, PhD student
Nurse, paramedic, technician, data manager or student
My specialty is
My Membership 2019 subscription:
Note: Only the organizer can cancel the chosen fee options when you have already paid.
Total: € 0.00
Some required fields have not been filled out ().
Membership BSTH firstname.lastname@example.org
Membership BSTH 2019Membership BSTH 20190.00EUR
Membership BSTH 2019Membership BSTH 2019Phoenixstraat 28b, Delft
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