Membership German BioImaging - GMB e.V. | German BioImaging - Gesellschaft für Mikroskopie und Bildanalyse e.V.

Membership Application German BioImaging - Gesellschaft für Mikroskopie und Bildanalyse e.V.

I hereby apply for membership in German BioImaging - Gesellschaft für Mikroskopie und Bildanalyse e.V. (GerBI-GMB). Membership starts with the written notification that the Board has decided on admission. There is no entitlement to admission. In the case of confirmed admission, voting membership begins after the first payment has been received.

Name^*

Surname^*

E-Mail address^*

Date of Birth ^*

Institution ^*

Position^*

For personal members, please enter your personal address below. Corporate and institutional members may enter their company or institute address.

Street^*

PLZ^*

Stadt^*

Country^*

I acknowledge the statutes of the association and hereby allow the association to use the personal data for the administration of the membership.^*

GerBI-GMB Teams

GerBI-GMB is organized in different teams (for details, please see here). If you would like to join a GerBI Team, please indicate which one it is. The workgroup speaker of the respective workgroup will get in touch with you about future meetings and workgroup activities. If you don't intend to join a workgroup now, you can choose to join at any time of your membership. Please get in touch with the GerBI office for details.

GerBI Team (optional)

Membership

Membership options for German BioImaging - Gesellschaft für Mikroskopie und Bildanalyse e.V. (GerBI-GMB, Society for Microscopy and Image Analysis, for details, please see here):

Individual Membership: Individual persons (for (PhD-) students reduced fee)
Annual contribution: 100€; Students (with certificate): 40€
Institutional Membership: Associations, organizations and other public legal entities or persons, also scientific institutes. Up to 12 persons can be registered.
Annual contribution: 1000€
Corporate Membership: Bronze-, Silver-, or Gold-Status, Companies and other private legal entities or persons.
Annual contribution: 2000€ (Bronze), 5000€ (Silver), 10000€ (Gold)

Membership option^*

Payment method^*

In case you chose direct debit (Lastschrift): Thank you, this helps us a lot during our daily work within the association! Please fill in the details of the SEPA mandat below.

SEPA Direct Debit Mandat

Name of debtor

IBAN (IBAN)

BIC (BIC)

Note: As part of your rights, you are entitled to a refund from your bank under the terms and conditions of your agreement with your bank. A refund must be claimed within 8 weeks starting from the date on which your account was debited.

I hereby authorize the association GerBI-GMB e.V. to collect payments from my account by direct debit. At the same time, I instruct my credit institution to honor the direct debits drawn on my account by the GerBI-GMB e.V. association. The data will be stored for association administration on electronic data carriers during the membership. The conditions agreed with my credit institution apply. Creditor identification number: DE37ZZZ00002041832. The mandate reference will be communicated separately.

General

I am interested in joining GerBI-GMB because ...

Membership Cancellation Terms ^*

The cancellation of the GerBI membership must be submitted at least 3 months before the end of the calender year as stipulated in our statutes.
I have taken note of these cancellation terms.

I agree that other members may see the following personal information about me: First name, Last name, Email. ^*

Einverständniserklärung ^*

Ich bin damit einverstanden, dass meine Daten vom "German BioImaging - Gesellschaft für Mikroskopie und Bildanalye e.V." zum Zweck der Vertragserfüllung im Rahmen der Mitgliedschaft hinterlegt, verarbeitet und genutzt werden.

Ich bin darauf hingewiesen worden, dass die im Rahmen der vorstehend genannten Zwecke erhobenen personenbezogenen Daten unter Beachtung der EU-Datenschutzgrundverordnung, erhoben, verarbeitet, genutzt und übermittelt werden. Ich wurde über meine Rechte als betroffene Person unterrichtet.

Die Einverständniserklärung erfolgt auf freiwilliger Basis. Ich wurde darüber aufgeklärt, dass ich die Einverständniserklärung jederzeit durch schriftliche Mitteilung für die Zukunft widerrufen kann.

Bevor der Antrag abgesendet werden kann, muss die E-Mail Adresse verifiziert werden

Dokument hochladen

Inhalt des Dokuments:

Membership Application German BioImaging - Gesellschaft für Mikroskopie und Bildanalyse e.V.

GerBI-GMB Teams

Membership

SEPA Direct Debit Mandat

General

Die E-Mail wurde verifiziert