Membership application form

Please fill in your personal details. Items marked with a * are required.

Title
First Name *
Name *
Nationality *
Date of birth *
Address *
City *
Post Code *
Country *
Tel. *
Work tel.
Fax
Email *
Job Title *
Employer *, if you are retired, please write "NONE"
Organisation *
Academic/Professional Qualifications
When and Where Obtained
Application for: *

CHOOSE YOUR DESIRED MEMBERSHIP CATEGORY *


MODE OF PAYMENT : » for individual members: you'll receive your membership card as soon as you're registered by our administration; for embassies and corporate members: as soon as you have paid your annual fee by bank transfer: CCP 000-0000020-20, (Are you living within the EU region, please use this BE 28 0000 0000 2020; {BIC: BPOTBEB1} ) you'll receive your membership card! You'll be requested to register for each public event and in all cases to show your membership card.



IF your browser cannot send forms, please print and return the completed form to: IRRI-KIIB, Rue de Namur 69, 1000 BRUSSELS, Belgium. You can also print this application form and fax it to: +32 (0) 2 223 41 16. YOU will receive then YOUR MEMBERSHIP CARD as soon as you have paid the required amount to C.C.P. 000-0000020-20 (Are you living within the EU region, please use this BE 28 0000 0000 2020; {BIC: BPOTBEB1} . The information collected on this document is intended for the internal use of the Royal Institute for International Relations. They are covered by the provisions of the Belgian law of 8 Dec. 1992 pertaining the protection of private life with regard to the use of data.

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