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Great that you want to join us!

Joining GSAV Vitalis is very easy and consist of three steps:

1. Complete this form
2. Confirm your registration by clicking the link in the confirmation email
3. Approval of your application by the membership records. Upon approval, you will receive a confirmation email again

The membership of G.S.A.V. Vitalis runs from 1 Januari until 31 December. The contribution due in 2010 is €30,-. Aditionally you have to pay licencing fees for the national athletics union. In 2010, for 'recreant' and 'wedstrijdlid' the amount is respectively €14,55 and €34,25. New members, and members that want to transfer their license have to pay a one time administration (in 2010 respectively €5,95 and €8,40). Between September and December it is possible to join Vitalis against a reduced fee of €10,- for this period.

Userdata

Specify a username and password that can be used to access the private part of the Vitalis website.

User name:
Wachtwoord:
Wachtwoord (herhaal):

Address

Firstname:
Initials:
Insertion:
Surname:
Street:
Number:
ZIP code:
City:

Personal

Sex:	Male Female
Date of Birth:
Telephone number:
Email:
Dutch Bank Account Number:
University:	Rijksuniversiteit GroningenHanzehogeschoolStenden HogeschoolAfgestudeerdOverige
Study:
For RuG students, this is your student number. For students from the Hanze University, this is your NAW number. Make sure you are a member of the ACLO. If you do not qualify for a ACLO member ship, contact our secretary for our dispensation policy.
ACLO-card Number:

Club

Training Group:	mlasprintgroepbasisgroepinstroomgroeptechnische groep
If you want to participate in offical athletic competitions, you need an official licence from the national athletics union ('wedstrijdlid'). If you do not want to participate at official events, or only at student championships (NSK) a 'recreant' membership suffices.
Member Type:	wedstrijdlidrecreant
If you are currently a member of a Dutch athletics club, please fill in your union number of the 'Atletiekunie'.
Number National Athletics Union:

Overschrijven van / Wedstrijdlid bij:
If you have a 'wedstrijdlicentie', please indicate whether you want to transfer your 'wedstrijdlicentie' to Vitalis. Just a recreative member of your current club? Then your licence will be transferred to Vitalis automatically.
Transfer to Vitalis:	Yes No

Remarks:
I have completed this form correctly and I am aware to be responsible for the transmission of changes. I grant permission (until further notice) to GSAV Vitalis to automatically withdraw amounts for union dues, costs of ordered clothing and expenses related to participation in activities from my bank account. I do agree that my data are published in the online Almanac (privacy settings can be adjusted)

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