I wish to become a member of the GSb!

I wish to be:
 active somewhat active
I wish to receive the magazine Nait Soez\'n (in Dutch only):  

Name:
Adress:
Postal code:
Residence:
Phone number:
Email address:
Study:
Student number:
 Hanze University (RUG)
Bank account:

I hereby entitle the GSb to automatically transfer the annual contribution fee of €10 from my account. I agree with the conditions set out below.

Conditions of entitlement:

1) Contribution is deducted from your account once a year at the end of the month
2) Membership and thus entitlement can be cancelled at any time by sending a note or email to the GSb
3) It is possible to order your bank to return your money within 30 days from the date of of the transaction.