Registration form for Education and trainees Education Education Personal Last name Prefix Initials First name Date of Birth mm-dd-yyyy Place of Birth Gender Male Female Street House number /  Addition   Postal code City BIG-Registrationnumber Email   Email  (Retype email to verify)   Telephone 1 Telephone 2 Startdate mm-dd-yyyy Attachments Upload a copy of your Passport BIG-Registrationnumber Institute / hospital Name Street House number Postal code City Department Function Phone work Contact person Function Email   My manager agrees with my registration   Invoice Department Street House number Postal code City Retype code to verify         I agree with the terms and conditions   I agree with the cancellation rules.     Lid 1. Annulering van de opleiding dient altijd schriftelijk te geschieden.   Lid 2. Bij annulering tot 6 weken vóór de start van de opleiding wordt € 75,- administratiekosten aan de werkgever in rekening gebracht.   Lid 3. Bij annulering minder dan 6 weken vóór de start van de opleiding worden de totale opleidingskosten in rekening gebracht aan de werkgever.