You are affiliated with CM as a dependent

Do you want to join in your own name (as a beneficiary), for example because you are starting to work or are entitled to an integration benefit?

Are you a member of CM, registered as a dependent? To join as a beneficiary (e.g. because you start working or become entitled to an integration benefit), complete the application below and forward it.

We will contact you as soon as possible to arrange your connection as the entitled party.

Identificatie
Geslacht
Hoofdverblijfplaats
Statuutwijziging
Reden statuutwijziging
Interesse voor extra (aanvullende) CM-verzekeringen