Online membership form ACOD Ghent University


Personal details:
Last name:
First name:
Sexe: man
woman
Birth date:
Belgian national number:
Marital state:


Contact details:
Street and number (and mailbox if applicable):
ZIP code and town:
Country:
Private e-mail address:
Private phone number:
Private mobile phone number:


Previous membership details:
Have you previously been member of ACOD, ABVV or another trade union?
You can add this below.
ACOD from start date to end date in the regional branch (province)

ABVV from start date to end date in the regional branch (province)

Other trade union: from start date to end date in the regional branch (province)

No previous membership

Last payment of membership dues which were made on this date:


Membership information:
Employer (current or last):
Workstation (= name faculty + name department/office, or name central direction + name department/office):
Central Administration (except DSV)
Directe Studentenvoorzieningen (DSV)
faculty or faculty department
Grade and function:
Street and number (and mailbox if applicable) of the workstation:
ZIP code and town of the workstation:
Country:
Office phone number:
Office e-mail address:
Working for this employer since:

Employment status:



Please specify if you have chosen -other- in the dropdown above:


Type of employment: fulltime
10 months/year
part time: %
retired
unemployed
other:

Start date membership:

Mode of payment of the membership dues: SEPA-order (automatic monthly payment)
wire transfer (every three months)
IBAN bank account number:
BIC-code:
Name of the account holder of the bank account number:
Name of the bank:

Comments:

Please note: after you will have submitted this form clicking the button below, you will soon receive some additional documents at your home address. Please complete and sign these documents, and send them back to the address indicated on them. Only then your membership will have been fully registered.