Regular membership application

Surname

First name

Street/No.

ZIP/Town

Billing adress (if different)

Phone No.

E-Mail

Academic Degree(s)

Please attach copies of your qualifications.

Größenbegrenzung: 10 MB

Current occupation

Please select your desired membership type

A

Regular membership (CHF 150.-/year)

B

Combined membership GESKES-SWAN (CHF 100.- + 120.-/year)*

C

Combined membership VDOE-SWAN (CHF 100.- + € 105.-/year)*

D

Combined membership VEÖ-SWAN (CHF 110.- + € 75.-/year)*

* Combination memberships must be applied for in person at the respective cooperation partner. The reduced contribution fee will only be granted if this has been done.

In case of a change in the form of membership (e.g. taking up studies, joining/leaving VDOE) SWAN must be be informed as soon as possible, at the latest by December 15 of each year. Please attach supporting documentation.

Data usage Mailchimp

II agree that my first and last name as well as my e-mail address for the SWAN newsletter and event invitations (e.g. general meeting) will be saved at Mailchimp.

SWAN welcomes new members in its newsletter: I agree to my first name and surname being mentioned in the next newsletter.

A

Yes.

B

No, I do not wish to be mentioned by name.

With my signature I confirm the truthfulness of my data as well as my membership in the association SWAN - SWiss Academic Nutritionists and accept its statutes. Furthermore, I undertake to protect the interests of the association and to pay the membership fee. I am aware that the board of SWAN will review my education and reserves the right to refuse my membership.

Place, date

Unterschrift

Notes of the association: All data provided is treated confidentially by SWAN and used only for internal purposes. Got everything?

Please check that all documents have been enclosed (diplomas and certificates).

Attachments

Größenbegrenzung: 10 MB

SWiss Academic Nutritionists, www.swan-nutrition.ch Könizstrasse 161, 3097 Liebefeld, [email protected]