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REGISTRATION FORM

First name*

Last name*

Gender*
MF

Date of Birth*

Country of Birth*

Place of Birth (Municipality)*

Place of Birth (Province)*

City of Birth*

Region/Province/State of Birth*

Email*

Phone number*

I am currently enrolled at the University of Pisa*
YesNo

Degree Course*

Year attended*

Please select the option that best describes you

University*

Degree Course*

Year attended*

School*

City*

Year attended*

Degree course*

Year of graduation*

Employer/Company (optional)

Job

How did you learn about EUROAVIA Pisa?*
WebsiteFacebookPresentation in classStand at the School of EngineeringPoster at universityFlyerFriends' adviceOther

Do you have any special requests?

Statute of the Association and payment of the annual membership fee.
I have read and accept the Statute of EUROAVIA Pisa in all its terms and I hereby commit to pay the annual membership fee.*

Privacy policy

I have read and accept the privacy policy and authorize the treatment of my personal data according to the current Italian data protection law (Decreto Legislativo 30 giugno 2003, n. 196).*

Liability waiver declaration

I have read and accept the 'Liability waiver declaration' and agree to all its terms and conditions.*

Authorization for the recording, editing and publication of images, videos and sound recordings

I have read and accept the 'Authorization for the recording, editing and publication of images, videos and sound recordings' and agree to all its terms and conditions.*

EUROAVIA Membership Database privacy declaration

I have read and accept the 'EUROAVIA Membership Database privacy declaration' and agree to all its terms and conditions.*