Individual, Professional – Moon Village Association

Terms:

€50 / Year

First Name:* First Name Required

Last Name:* Last Name Required

Address Line 1:* Address Line 1 is Required

Address Line 2: Address Line 2 is not valid

City:* City is Required

Country:* Country is Required

State/Province:* State/Province is Required

Zip/Postal Code:* Zip/Postal Code is Required

Mobile:* Mobile is Required

Affiliation:* Affiliation is Required

Short biography:* Short biography is Required

Nationality:* Nationality is Required

City:* City is Required

Postal Code:* Postal Code is Required

Country:* Country is Required

Date of Birth:* Date of Birth is Required

Gender:* Gender is Required

What do you want to get out of MVA and what can you contribute?: What do you want to get out of MVA and what can you contribute? is not valid

How much time can you dedicate to MVA per month?:* How much time can you dedicate to MVA per month? is Required

Consent to be invited to our Slack Workspace and added to the relevant working group mailing lists.

Signature: I hereby declare to be a Member of the Moon Village Association and pay the annual membership fee.*

Email:* Invalid Email

Password:* Invalid Password

Password Confirmation:* Password Confirmation Doesn't Match

Password Strength Password must be "Medium" or stronger

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Terms: €50 / Year

Description	Amount
Individual, Professional – Initial Payment	€50.00
Total	€50.00

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