Request NFAA membership

Via this form, you can issue a request for a NFAA membership.
After you have submitted the data, you will recieve a confirmation of the request at the given email address. When your request has been confirmed by the NFAA boars, youŽll recieve a final confirmation. YouŽll also recieve a username to access the protecte sections of this website.

* Initials * Prefix  Name *
First name: *
Date of birth: *(dd-mm-yyyy)
Titlel: *
Address: *     *
Zipcode / City *   *
Phone, private:
Phone, mobile:
Email, prim: *
Repeat *
Email, alt:
Memberlist: 1

US Scholarship Year     Discipline 
Host univ     NL univ 

* Mandatory field
1 The member list is only visible for NFAA members after login