Membership test – E Pluribus Unum

EPU Membership Form

BECOME A MEMBER

The EPU membership fee is only €20,- per year for full American Studies members and €10,- for companion members. To become a member, please fill out all the boxes in the form below.

Your membership will be renewed automatically and your membership fee will be withdrawn from your bank account at the start of the new year. In order to cancel your EPU membership, please notify the EPU secretary at secretary@svepu.nl before September 1st. Cancelation of the membership after September 1st will mean the contribution of that year is still due. Your membership will not automatically be canceled upon completion of studies

Personal Details

First Name

Last Name

Date of Birth

Phone Number (Including Area Code)

Study information

Companion members do not study American Studies, but are still part of our association. They pay a reduced member fee.

Member Type

Starting Year

I am currently enrolled in the

S-Number

Payment Information

Your bank information will only be used for the withdrawal of your annual membership costs and costs of EPU activities you signed up for and agreed to pay for. The address information is required for authorizing the SEPA payment. EPU will not use this information for any other purposes.

Initials + Surname of the Bank Account holder

Address Information

Street

House Number

Postal Code

City

Country

IBAN

BIC

Sepa Direct Debit Mandate

By signing this mandate form, you authorise (A) Study Association E Pluribus Unum (creditor ID: NL06ABNA0468748490) to send instructions to your bank to debit your account and (B) your bank to debit your account in accordance with the instructions from Study Association E Pluribus Unum. As part of your rights, you are entitled to a refund from your bank under the terms and conditions of your agreement with your bank. A refund must be claimed within eight weeks starting from the date on which your account was debited. Your rights are explained in a statement that you can obtain from your bank.

Preferences

Below you can inform us about your preferences concerning privacy

I agree that EPU is allowed to use my phone number for communication about EPU matters.

I would like to be added to the EPU group chat on WhatsApp

I agree that it is possible that my picture can be taken at activities organised by EPU. I accept that such pictures might be used on the website, Social Media or in the Almanac (yearbook) of EPU.

Yes, I agree with the Privacy Policy and agree to sign-up as a member of E Pluribus Unum (EPU).