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APPLICATION FOR MEMBERSHIP OF 5G WORLD ALLIANCE LIMITED

APPLICANT DETAILS

Company:

Address:

Country:

Telephone: Website:


PRIMARY CONTACT

Name: Telephone:

Email:


INVOICING DETAILS

Registered Company Name:

Registered Company Number:

Address Details:
(if different from applicant’s details)

Country:


DETAILS OF PERSON AUTHORISING PAYMENT

Name: Telephone:

Email:


MEMBERSHIP FEES

Fees are for a 12 month period. Please tick the required membership:

 Platinum Gold Silver Bronze

I, on behalf of the organisation detailed above, apply to become a member of 5G World Alliance Limited.

Name:

Date:

I declare that I am authorised by the above named organisation to act on its behalf.
I understand our membership will continue for a full twelve months from payment of the fee.
Confirmation of your acceptance as a member of NICC Standards Limited will be sent within 28 days.
DATA PROTECTION NOTICE
Information provided by you on this form will be processed by 5G World Alliance and used solely for
communications with you regarding matters relating to your membership of 5G World Alliance.
Your details will not be passed to third party organisations.

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