Application form

Full name:

Home address:

City:

Country:

Personal identification number (OIB in Croatia):

Person Master Citizen Number (JMBG in Croatia):

Academic title:

University finished:



Institution of employment:

Department/Unit:

Institution’s address:

City:

State:

Phone (job):

Mobile phone:

E-mail:

Telefax:

Date of application:

I confirm that I am aware of and accept the rights and obligations related to membership, and determined by the By-Laws of HDBMB
I confirm that my personal data can be used for the purpose of HDBMB activities.
I want to receive information from HDBMB.