MEMBERSHIP APPLICATION FORM Hidden fields Name of the Company/Organization Company Headquarters Mailing Postal Address Official Telephone No. Official E-mail Address Web Page Applicant's Name Applicant's Telephone No. Applicant's E-mail Address Official Representative's Name Official Representative’s Email Address Head of Finance Department Name Finance Officer Email Address Head of Legal Department Representative Legal Officer Email Address Level of Membership Applying for Patron (4,000 EUR)Corporate (2,000 EUR)Medium (1,000 EUR)Small Business (700 EUR)NGO (500 EUR)Individual (300 EUR)Startup Member (250 EUR) Main Activity of Your Company/Organization Business Registration Number Fiscal Number VAT Number Legal Form of Registered Company Primary Business Sector Year of Registration Does your company/organization represent a U.S. based business? If yes, please specify If your company is based in the United States, specify the city and the country State Country If your company is based in the United States and has a European headquarters, please list the European city and country State Country Does your company currently import U.S.-manufactured products? If yes, please describe briefly. Size of Company (number of employees); please specify
