Application Form

PERSONAL DATA COLLECTION
The personal data provided by you will be used for BHKS-related purposes only and may be shared with third parties for relevant purposes.

Application form

CORPORATE MEMBERSHIP(?)
INDIVIDUAL MEMBERSHIP(?)
YOUNG MEMBERSHIP(?)


Title*
Title*

Last name*
Last name*

First name*
First name*

Position
Position

Address (Street and Number)*
Address (Street and Number)*

Zip code and City*
Zip code and City*

Country*
Country*

Telephone (1)*
Telephone (1)*

Telephone (2) Telephone (2)

Fax Fax

E-mail*
E-mail*


Membership Fees

Depending if you are Individual Menber (EUR 75 a year)
or Corporate Member (EUR 200 a year) or Young Member (EUR 20 a year)


Methods of Payment :

Note :
By cheque: Please send the cheque in the name of the BELGIUM-HONG KONG to the Secretary, Belgium-Hong Kong Society, Rue d’Arlon 118, 1040 Brussels
By bank transfer: Please transfer the amount to the Society’s Account N° 310-0714657-47 / IBAN : IBAN BE22 3100 7146 5747 / Swift : BBRUBEBB with ING

Anti-spam *
Please tick the box « Tick this input box »
Do not tick this input box
Tick this input box
Do not tick this input box