Membership application form

Basic information

First name

Infix optional

Last name

Infix (tussenvoegsel) is a common thing in Dutch surnames. It’s separated from the rest of the surname to sort your surname with N instead of V if your name is John von Neuman. Leave this field empty if you don’t know what to do with this.

Birthdate

Contact

Email address

Please use your personal email, NOT your university email. Then we can still contact you about your membership after your graduation. We’ll send you an email with a confirmation link after completing this form.

Phone number

Address

Street name + number

Postal code

Place of residence

Study

Student number

Study

Phase

Starting year

Payment

IBAN

BIC optional

BIC is only required if your IBAN does not start with ‘NL’

SEPA direct debit mandate

I hereby authorize Cover to automatically deduct the membership fee, costs for attending activities, and additional costs (e.g. food and drinks) from my bank account for the duration of my membership. required

By checking this box, you authorise (A) study association Cover (ID: NL48ZZZ400267070000) to send instructions to your bank to debit your account and (B) your bank to debit your account in accordance with the instructions from the Creditor. 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. Your rights are explained in a statement that you can obtain from your bank.

If you update your personal details or account number in your Cover account, these changes will be reflected in the mandate.

The undersigned (you) hereby applies for a membership of Cover, the study association for Artificial Intelligence, Computing Science, and Computational Cognitive Science.

The undersigned (you) hereby agrees to comply with the following requirements during their membership.

You are required to enter their personal details correctly and to keep them up to date. You can do this through your profile on the Cover website, or by sending an email to the secretary at secretary@svcover.nl.
You are a member until you cancel your membership. Termination of membership shall be done in writing to the secretary at secretary@svcover.nl.
The membership fee is € 10,- per year.
Your data will be handled in accordance with our privacy statement.

I agree to the terms and conditions. required