Registration

Credentials

E-mail*

Preferably a gmail address.

Password*

Repeat Password*

Personal information

First name*

Last name*

Birthdate*

Student number*

Mobile phone number*

Starting year of study*

Payment information

The most convenient way of paying is by authorising CognAC to deduct money from your bank account. If you do not want that you can also sign up by paying cash, that can be done at the board room of CognAC.

IBAN*

BIC

Only necessary for non-dutch banks.

Account holder*

Type of membership*

I want to receive emails from CognAC regarding events, vacancies or other activities hosted by partners of CognAC
I accept and agree with the privacy statement of SV CognAC.*
I allow SV CognAC to perform money transfers from my bank account after being informed about them via mail for membership fees and services provided by SV CognAC. If you do not agree with the collection of money from your bank account, you can reverse the entry. Contact your bank within 8 weeks after the collection. Ask your bank for the terms and conditions.*

Credentials

E-mail*

Preferably a gmail address.

Password*

Repeat Password*

Personal information

First name*

Last name*

Birthdate*

Student number

Mobile phone number*

Payment information

IBAN*

BIC

Only necessary for non-dutch banks.

Account holder*

Contribution amount (min. of 10€)*

Registrations after the 15th of July will not end by the next september but instead the one after. I want to be a benefactor of CognAC until the end of the academic year and will pay the contribution once.
I want to be a benefactor of CognAC until resignation and will pay the contribution yearly.

I want to receive emails from CognAC regarding events, vacancies or other activities hosted by partners of CognAC
I accept and agree with the privacy statement of SV CognAC.*
I allow SV CognAC to perform money transfers from my bank account after being informed about them via mail for membership fees and services provided by SV CognAC. If you do not agree with the collection of money from your bank account, you can reverse the entry. Contact your bank within 8 weeks after the collection. Ask your bank for the terms and conditions.*