Individual Registration

First name*
Last Name*
Organization
Address*
City*
Country*
Zip*
Phone*
Email*
Date of birth*
Degree*
Profession*
Employer
References
Education*
Studied literature*
Experience*
Motivation*
Payment Method	Offline Payment
Credit Card Number*
Expiration Date*	/
Card (CVV) Code*
Card Type*
Card Holder Name*
iDeal Bank*
Comment
Enrollment is complete after: confirmation of your participation; receipt of our invoice; payment 6 weeks at the latest before beginning of the training on IBAN NL37 INGB 0004 4885 14 to the name of Dutch University College. Cancellation: In case of cancellation within the specified time of payment € 50,= will be charged for administration and organization expenses.