First name

Last name

Email address

Gender:
MaleFemale

Street + number

Postal code

Place

Phone number

Date of birth

Place of birth

Study + year

Studentnumber or ANR

Referee diploma of the NBB (Dutch Basketball Association)
BS2/FBS3/EBS4/DNone

Trainersdiploma of the NBB (Dutch Basketball Association)
BT2BT3BT4None

Previous association

Years of basketball experience

The undersigned declares to become a member of the Tilburgse Studenten Basketball Vereniging Pendragon.
Herewith the undersigned declares to agree with the Rules and Regulations of the association.
(to be found at www.tsbv-pendragon.nl under Association under documents)

Some rules according to the house hold policy that deserve extra attention:
- The undersigned agrees to pay dues.
- The undersigned has taken or is willing to take a table course during the 1st season.
- The undersigned is required to perform table duties.
- The undersigned holds or is willing to obtain referee certification.
- The undersigned is required to referee at his/her own level (excluding beginners).
- The undersigned agrees to the association's penalty policy.

The contribution (determined in the General Meeting) will be met as follows:
Full amount at once (last week of October)In two installments (last week of October and last week of January)

What kind of member do you want to be?
Full seasonHalf season Sept. till Jan.Half season Jan. till June

Ondergetekend machtigt hierbij TSBV Pendragon om jaarlijks, tot wederopzegging, de verschuldigde contributie af te schrijven van onderstaande rekening volgens de regels uit artikel 5 uit het Huishoudelijk Reglement.

Bank details (IBAN)

In the name of

Upload your passport photo here

I understand that my subscription is definitive when I sign this autograph