Aangesloten bij/Associated with:

International Federation of Shipmasters’ Associations (IFSMA)

Confederation of European Shipmasters’ Associations (CESMA)

 

A A N M E L D I N G S F O R M U L I E R/M E M B E R S H I P  APPLICATION FORM

 

Ondergetekende/Undersigned

 

 

Diploma/Certificate........................................ Geb. datum/Date of birth ..............................

 

Varend als/Employed as: .......................................................................................................

 

Ex/Formerly employed as:.......................................................................................................

 

Gepensioneerd/Retired.:........................................................................................................

 

Rederij/Shipping Co.:..............................................................................................................

 

Huisadres/Home Address:.....................................................................................................

 

Postcode-woonplaats/Postcode(zipcode)-Residence: .......................................................

 

Telefoon/Telephone: ...................................................e-mail:...............................................

 

 Membership number IFSMA( if applicable):............................................................................

 

Verzoekt hiermede om toe te treden als lid van de NVKK  middels het introductielidmaatschap

(Het introductielidmaatschap voor een periode van 2 jaar bedraagt € 75 +€ 12,50 entreegeld).

 

Wishes to join the NVKK as International Member by means of the introductory membership.

( € 75,-  + € 12,50 administration fee for the first 2 years).

 

Maakt gebruik van het kortingsabonnement op het magazine SWZ Maritime,

 € 35 per jaar*  ........................................................................................................................               

...................................................................................................................................... Ja/Nee

 

Wishes a reduced subscription on the magazine SWZ Maritime, € 35 per year*  

..................................................................................................................................... Yes/No

 

*) postadres in Nederland/postal address in NL

 

 

 

                                                                     Handtekening/ Signature:..................................