I hereby wish to apply for membership of SIODEC as a:
General MemberStudent


PERSONAL DETAILS

Full name

Email (required)

ID or Tax number

Address (required)

Town (required)

Post Code (required)

Province (required)

Country (required)


PROFESSIONAL DETAILS

Name of practice (required)

Work address (required)

Town (required)

Post Code (required)

Province (required)

Country (required)

Work telephone (required)

Mobile (required)

Email (required)

Profession (required)
OptometristVision TherapistOther:

If you are an OPTOMETRIST, please indicate the different types of treatments carried out in your practice:
Vision Therapy (VT)Primitive Reflexes Therapy (PRT)Rhythmic Movement Therapy (RMT)Traumatic Brain Injury (TBI)Syntonic Phototherapy (SP)Orthokeratology (ORK)Auditory Therapy (AT)


BANK DETAILS

Account holder (required)

Bank (required)

Account number (IBAN) (required)

How did you hear about us? (required)
InternetRecommendation from a member of SIODECRecommendation from a friend or acquaintanceThe mediaSocial NetworksOther:

Comments

By sending this form I authorise SIODEC to set up a direct debit to the bank account stated for payment of the membership fees.

In accordance with Organic Law 15/1999 on Data Protection and the regulations stipulated therein, SIODEC guarantees it will take the necessary measures to ensure the confidential treatment of said data and informs you of the possibility of exercising your right to access, rectification cancellation and opposition in accordance with said legislation, by writing to SIODEC at their registered office in Calle Orense, 7, Madrid 28020.
Likewise, you hereby authorise SIODEC to transfer the personal data provided to third-party companies whose intervention may be deemed necessary. According to the LO (Organic Law) 15/99 of December concerning the Protection of Personal Data, we hereby inform you that your data will be included in a file owned by SIODEC, before whom you may exercise your rights of access, rectification and cancellation. SIODEC shall treat the data in accordance with the agreed purposes, and will only pass it on to third parties whose intervention may be necessary.