First name Surname Date of birth (dd/mm/yyyy) Adress Zip code & city Phone Your Email University ---UvAVU Studentnumber Are you a Dutch or International student? ---DutchInternational Are you following a bachelor or master course? ---BachelorMaster Full name account holder Bank account (IBAN) BIC Bank & City Hereby I become a member of ELSA Amsterdam and authorize ELSA Amsterdam to automatically debit my account for a yearly 15 euro-fee until I cancel my membership. This has to be done one month before the end of the academic year either by email or by letter. For exchange students its also possible to pay cash.