Membership_Form

Membership Type:

Individual, 150 per annumSME, 400 per annum ( Company Representative delegates)Corporate, 825 per annum ( Company Representative + 5 delegates)

- Payment can be made to any one of the following bank accounts:

- BGL, Swift: BGLLLULL, A/C No. LU03 0030 6733 4505 0000

- Dexia Banque Internationale a Luxembourg, Swift: BILLLULL, A/C No. LU32 0028 1915 6346 3600

Date:

Company Name :

No. Of Employees:

Country :

Postal Code :

Registration of Commerce No :

V.A.T No :

Company Representative / Individual Member Information

Name :

Position Held / Title :

Email :

Telephone :

Details of additional company delegates (in addition to representative)

Not applicable for individual member, SME members (up to 2 delegates), Corporate members (up to 5 delegates)

Name :

Position :

Email :

Phone :

Name :

Position :

Email :

Phone :

Name :

Position :

Email :

Phone :

Name :

Position :

Email :

Phone :

Name :

Position :

Email :

Phone :

Details of additional company delegates (in addition to representative)

Not applicable for individual member

Details of additional company delegates (in addition to representative)

SME members (up to 2 delegates)

Name :

Position :

Email :

Phone :

Name :

Position :

Email :

Phone :

Details of additional company delegates (in addition to representative)

Not applicable for individual member Corporate members (up to 5 delegates)

Name :

Position :

Email :

Phone :

Name :

Position :

Email :

Phone :

Name :

Position :

Email :

Phone :

Name :

Position :

Email :

Phone :

Name :

Position :

Email :

Phone :

Membership Application Form

Company Representative / Individual Member Information

Please advice your company activities (check all applicable)

Details of additional company delegates (in addition to representative)

Details of additional company delegates (in addition to representative)

Details of additional company delegates (in addition to representative)

Details of additional company delegates (in addition to representative)