for ordinary membership (bank account in Europe)

Registration for ordinary membership

Please note:

If you do not have a bank account in Europe, please use an other registration form.
By subscribing this registration form, you accept the condition for foring membership.
The details marked with (!) will be displayed in the password protected member list. This member list can be accessed only by ordinary foring members.
Please use English terms and English letters (do not use ü, é, etc.).

* Indicates required field

Name (!) *

First

Last

E-Mail-Address (!) *

Adresse *

Line 1

Line 2

City

State

Zip Code

Country

Phone-Number *

Gender *

Male Female

Year of birth *

Country of Residence (!) *

Profession (!) *

Level of training (!) *

Speciality (!) *

Subspeciality (!) *

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Years of working experience in developing countries (!) *

Developing countries worked in (!) *

Organizations worked for (!) *

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Interest in giving lectures (!) *

YES NO

Topics for lectures (!) *

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How did you hear about foring? *

I am interested in the foring newsletter: *

YES NO

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Comment *

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Amount of membership fee (in Euro) *

Name of account holder *

IBAN (international bank account number) *

Name of the bank *

BIC (bank identifier code) *

Creditor/Zahlungsempfänger:

Creditor identifier/Gläubiger-Identifikationsnummer:
Mandate reference/Mandatsreferenz:

foring - Forum für Internationale Gesundheit/Forum for International Health
Taxisstr. 21 - 80637 München - Germany
DE70ZZZ00001163582
to be completed by foring/wird separat mitgeteilt

Sepa Direct Debit Mandate *

I authorise foring to send instructions to my bank to debit my account and my bank to debit my account in accordance with the instructions from foring. Note: I can, within eight weeks, starting with the date of the debit request, demand a refund of the amount charged. The terms and conditions agreed upon with my financial institution apply.

SEPA-Lastschriftmandat
Ich ermächtige foring, Zahlungen von meinem Konto mittels Lastschrift einzuziehen. Zugleich weise ich mein Kreditinstitut an, die von foring auf mein Konto gezogenen Lastschriften einzulösen. Hinweis: Ich kann innerhalb von acht Wochen, beginnend mit dem Belastungsdatum, die Erstattung des belasteten Betrages verlangen. Es gelten dabei die mit meinem Kreditinstitut vereinbarten Bedingungen.

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I give the mandate / Ich erteile das Mandat.