Subscription Form ICT Group

ICT Employee Participation Plan 2026 (‘Plan‘)

Inschrijfmodule ICT Group

"*" indicates required fields

By submitting this subscription form you declare that:

You agree with the conditions by clicking the boxes on the left side.

The transferred amount will be visible in your Captin account. If you do not yet have an account, one will be created for you after approval from ICT Group, After approval, you will receive a username and password.

Having submitted this form you will receive an email confirmation.

Employee number*

Gender*

Mr.

Mrs.

Initials*

First names*

Surname*

Date of birth*

Day
Month
Year

E-mail address*

Mobile phone number*

I would like to participate for

Amount*
Please enter a number greater than or equal to 10.

in the ICT Employee Participation Plan 2026. (Registration takes place in whole certificates, i.e. in amounts of EUR 10,-)

IBAN (current account)*