Membership form

Membership form

In order to become a member of the Société Internationale des Amis de Mohammed Dib, please fill in the form below. Your personal data will only be used for the membership and for the information purposes of the SIAMD (distribution of the biannual bulletin, invitation to events and meetings).

We would like to point out that your membership will only be effective once we receive your membership fee that we kindly ask you to pay within two weeks of your online registration. The payment details will be sent to you in a return e-mail after your registration. The membership is valid for one academic year at a time, i.e. from 1 September to 31 August of the year the payment of the membership fee took place.

Questions concerning the membership of the SIAMD can be directed to administration[at]siamdib.com.

Fields marked with an asterisk (*) are mandatory.

Title*

Last name*

Given name*

Email*

Occupation

Address (city, country)

Type of membership*