Name: Netherlands Respiratory Society
Address: PO Box 5800, Maastricht, 6202 AZ
Telephone: +31(0)43 388 13 27

Title

Initials *

First name

Infix

Last name *

Institute *

Department *

(Invoice) address *

Postal code *

City *

Country *

Phone *

Email address *

BIG registration number (if applicable)

Date of birth *

Password *

Repeat password *

Membership type *

Research activities *

Clinical research

Basic research

Both basic and clinical research

Other (please specify)

Annual fee for membership NRS	€ 50,00
Annual fee for membership NRS-ERS	€ 70,00

Membership form