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Home page Home page Membership Click here to become a member Members area Enter A password is required to enter this section Contact Contact MEMBERSHIP - YEAR 2012 Membership Fee Year 2012 New!! Please notice you can now register for 2 or 3 years with reduced fee (only available for regular membership) New!! Special fees for Emeritus You can also print the PDF form for fax transmission to ECS secretary: Prof. Jan B. Parys Secretary-General ECS Lab. Molecular and Cellular Signalling K.U.Leuven Campus Gasthuisberg O/N 1 - bus 802 B-3000 Leuven, BELGIUM e-mail: jan.parys@med.kuleuven.be Title: DrProfMrMrsMiss First Name required Family name required E-mail address required ADDRESS DETAILS ONLY TO BE FILLED IN BY NEW MEMBERS OR IN CASE OF CHANGES Department/Laboratory required Institution required Address required Postal Code required City required Country required Phone number required Fax number required Tick the appropriate box: Regular Membership Regular Membership 2012-2013-2014 (156 €)   Regular Membership 2012-2013 (110 €)   Regular Membership 2012 (60 €) Emeritus Membership 2012 Emeritus membership 2012 (30 €)         Student Membership 2012 Student membership 2012 (30 €)         (For student membership, please send copy of ID student) Payment by credit card: Mastercard   Eurocard   Visa Please complete the card information Card number Expiry date Cardholder name Payment (others): Bank transfer to ECS account IBAN: BE95 0682 2443 2058 / BIC: GKCCBEBB (Bank Dexia, Blvd. Pacheco 44, 1000 Brussels, Belgium) (please join a copy)         In view of the very heavy fees imposed by banks, bank cheques can not be accepted. Sorry Do you need a receipt? Yes   No     If yes, please indicate e-mail address to which it has to be sent, if different from the above Back