Membership

We are delighted that you have decided to join the Harvard Club Berlin. The officers of the Club would like to extend a warm welcome to you. We hope that you will enjoy the many activities which the Club has to offer.

The minimum annual membership fee is minimum € 50. You are welcome to contribute any amount on top of the minimum membership fee. Upon payment of any membership or contribution, we will issue a receipt to file with your tax office (Spendenquittung).

Please use this form to join or renew your membership.You will be invoiced for the annual due amount which you specify.

If you wish to print out the application form and send it via fax, please use the printable form.

User name:*
Password:*

Name

Address:
Title, if any:
Last Name:*
First Name:*
Middle Initial:
Date of birth: yyyy-mm-dd
Nationality:
Name of spouse/significant other:

Degree

	Activities at Harvard
Graduation Year I:*
Degree:*
Faculty I:
Graduation Year II:
Degree:
Faculty II:
Industry

Home Address

Street1:*
Street2:
City:*
Zip Code:*
Country:*
Home Phone:
Home Fax:
Mobile Phone:
Home Email:*

Work Address

Job Title:
Company:
Street1:*
Street2:
City:*
Zip Code:*
Country:*
Work Phone:
Work Fax:
Work Mobile Phone:
Work Email:*

Banking details

Bank Code No.:*
Account Number:*
Bank:*
Annunal amount (minimum amount € 100):*

Delivery options

Delivery:

Please reply briefly:

	What are your special interests that should ideally be reflected in the activities of Harvard Club Berlin?
	Would you be willing to proactively support the activities of Harvard Club Berlin? If so, by what means?
	Are you member of other Harvard Clubs nationally and/or internationally beside Berlin? If so, which clubs?
	Would you be willing to participate in interviews/search for new Harvard College scholarship holders?
	Any other ideas: By submitting this formular, I agree that the following data shall be posted in the online membership directory, which is accessable for members only (last name, first name, harvard-degree and year, job title, email address).

For payment Method "Lastschrifteinzug", please print and fax Formular: Direct Debeting