Application for Membership for an Organizational Member

Fill in the following fields to apply for a COGAIN membership.

Organization

Name of the member organizarion: *

Street address:

City:

Postal code:

Country:

Contact

First name of the contact: *

Family name of the contact: *

Email address of the contact (used as a reference for the payment): *

Phone number:

Method of payment

Payment: *

Directly by bank transfer (see information below)

Please send an invoice

Information

The membership fee is 100 EUR. If you choose to pay by bank transfer, use the following information:

Name of the account holder: The COGAIN Association
Bank: Danske Bank (Denmark)
Registration number: 4733
Account number: 4800403367
IBAN account numer: DK0230004800403367
Swift-code: DABADKKK

IMPORTANT! Any bank or other charges for the transfer must be added to the payment!
Please use your email address given above as a reference for the payment.

Invoice address (if different from the address given above):

This field can be ignored if you choose to pay directly by bank transfer.

Additional information:

The membership will be effective after the Association receives the membership fee.
Membership fee period is one year. A reminder email will be sent for the next year's payment.

I accept the statutes of The COGAIN Association:

Not accept

You can help the COGAIN association by donating any amount of money.

Privacy statement | Contact webmaster@cogain.org

This is an inactive, outdated and archived site, kept for documentation purposes only. For up to date information, please visit www.cogain.org.

Communication by Gaze Interaction

Application for Membership for an Organizational Member