Guberna - Membership Request

Membership Request

Membership Type

Is For Guest Member

NoYes

Personal Info

Language

Gender

First Name

Last Name

Date of Birth

Salutation

Mobile Phone

Business Phone

Street and Number

Postal Code

City

Country

City

General Info

In what way did you get to know GUBERNA?

To continuously improve our services, we like to ask what are your expectations as a member of GUBERNA?

Yes, I would like to receive the monthly GUBERNA Newsletter

Yes, I authorize GUBERNA to keep my personal information in its database according to its privacy policy. I can withdraw my consent at any time by sending an email to privacy@guberna.be.

Yes, I accept the general terms and conditions

We are available to help you via phone (02 518 18 00) from Monday to Friday between 09:00 and 17:00. Outside of these office hours, please contact us via info@guberna.be and we will contact you as soon as possible.