Associates Application Form

ECT* ASSOCIATE SUBSCRIPTION FORM

Title

Surname

Name

Affiliation

Affiliation Address

Institution/Department/Street or PO box

City

Zip

Country

Email Address

Pursuant to art. 13 of EU Regulation No. 2016/679 (GDPR), we inform you that your personal data shall be
processed for the ECT* Association Subscription in order to give you the status of ECT* Associate. Full Privacy Policy is available at the following link.

I have read and agree with the policy about to the processing of my personal data by the FBK-ECT* staff

Yes

I am aware that my name, surname and the organization I work for may be published on the FBK-ECT* website, in the ECT* Annual Report, and possibly in ECT* promotional material (event posters, etc)

Yes

I consent to the mailing of institutional informative material by FBK staff

Yes, I consent

No, I do not consent