Request account for an individual

For now this form is available in Dutch only. We will provide an English translation as soon as possible.

"*" indicates required fields

First name*

Initials*

Last name*

Gender*

Male

Female

I don't identify myself with one of the aforementioned categories

Dutch citizen service number (Burgerservicenummer/BSN)*

If you live in the Caribbean part of the Kingdom and do not have a Dutch citizen service number, enter 9 times a 0 here (000000000).

Date of birth*

Email address*

This email address must be person-related and can only be used once in our application system. All correspondence concerning your applications will be sent to this email address. Your email address will be your login name. If you already have an account as an individual, or on behalf of another organization you can choose to also use this account for your applications, or a second account can be issued using a different email address.

Telephone number*

Have you previously submitted an application to the Mondriaan Fund as an individual?*

Yes

Do you have the Dutch nationality?*

Yes

We are asking this because, if you do not have the Dutch nationality, you will need to upload a recent extract from the Dutch Personal Records Database (Basisregistratie personen /BRP) or the Persoonsinformatievoorziening Nederlandse Antillen en Aruba (PIVA) in your applications to prove you are registered as a resident of respectively the Netherlands or the Caribbean part of the Kingdom.

Copy of ID*

Upload here a photo or scan of a valid passport or ID from the Netherlands or the Caribbean part of the Kingdom. For passports and IDs from the Netherlands, both your name and citizen service number (BSN) must be visible. For passports issued before August 2021, name and citizen service number are both on the personal ID card. For passports issued from August 2021, the citizen service number is no longer on the person card, but on the first page at the top. In this case, upload two images - separate or combined - of the first page with your citizen service number and of your personal ID card on which your name appears.

Drop files here or

Accepted file types: pdf, doc, jpg, jpeg, Max. file size: 4 MB, Max. files: 2.

Copy of ID*

Upload here a photo or scan of an official document on which both your name and Dutch citizen service number are visible. Examples include a Dutch driver’s licence, health insurance card, an extract from the Personal Records Database (BRP) of the municipality where you are registered, or correspondence from the Tax Administration (Belastingdienst) or, for example, the Ministry of Education, Culture and Science. If you do not have a Dutch citizen service number and reside in the Caribbean part of the Kingdom, upload here a recent PIVA (Persoonsinformatievoorziening Nederlandse Antillen en Aruba) extract no more than 1 year old.

Drop files here or

Accepted file types: pdf, doc, jpg, jpeg, Max. file size: 4 MB, Max. files: 2.

Comments

* mandatory