Request for Membership
Applicants Registration Form– Corporate Entity
In the name of the company...... , corporate entity, I hereby confirm our interest
to become a member of the Czech-Slovak ECR Initiative Association, registered at The Office ofCity Quarter
of Prague 1, under the registration number 129/01, Identification number: 70895031.
At the same time, I notify, that (company)...... is running its business/operations in the field of
………..………......
Company is running its business on (please tick one or both possibilities): Czech market
Slovak market
I hereby confirm, that I have read the contents of the Memorandum of Foundation and Bylaws of the CZ-SK ECR Initiative. I engagemyself to perform all duties sequent upon Bylaws of the ECR CZ&SK Initiative.I engage myself proactive approach to activities of CZ-SK ECR Initiative, to attend on meetings of advisory board and meetings of realization teams and to pay membership fee in time.
At the same time I declare that our company is prepared: to contribute by its experience and knowledge to ECR Initiative activities; to use ECR advanced techniques; and to undertake the role of initiator in the course of business procedures definition in the Czech and Slovak republics.
“Contact Details” information form represents obligatory attachment of this request. I engage to inform the ECR CZ&SK Initiativeabout changes, which have impact on data recency in the stated form. I hereby acknowledge that the above data and information are true and agree that ECR Initiative shall be entitled to use the name, trademarks, service marks, logos, trade names or any other symbols and/or branding of the company in marketing and publicity materials, and for internal purposes.I approve of adding our company personal datato the CZ-SK ECR Initiative database; ofits using in accordance to Personal Data Protection law, for needs of statutory organs of the initiative; and also of provision to the third party. I have the right to see, provide adjustments and delete my voluntary provided information and personal data.
Company stamp Signature of the authorized person
or statutory representative
Please send completed Request Form to this address:
CZ-SK ECR Initiative
Na Pankráci 30
140 00 Praha 4
This part of the request will be reviewed by ECR Presidium according to article no. 4.1. of Bylaws of the ECR CZ&SK Initiative.You will be informed about the decision in the written form in two weeks after the Presidium meeting.
Porozumienie ECR Polska, tel: +48 61850 4943, +48 61850 4981, fax: +48 61852 6376
Instytut Logistyki i Magazynowania,ul. Estkowskiego 6, 61-755 Poznań, NIP:777-00-20-410, REGON:000018603
Zarejestrowany pod nr KRS 0000052866 – Wydział VIII Gospodarczy Krajowego Rejestru Sądowego Poznań – Nowe Miasto i Wilda
Konto bankowe: Bank Zachodni WBK S.A., 6 O/Poznań nr 39 1090 1362 0000 0000 3601 7908
Contact Details
Company:TAX ID: / Company ID:
www: / E-mail:
Tel: / Fax:
Street:
Zip code: / City:
Country:
If the company address is different from the address for correspondence, please write it in the separate cells.
Additional Information:Contact detail of person, who represents the company in the Czech and SlovakRepublics ECR initiative (ECR Manager).
Persons on this list will be informed about the CZ-SK ECR Initiative events and will be involved in the cooperation according to the terms of Agreement. List of contacts can be changed and continuously updated.
Contact Person (for universal and organizational purposes and for needs of statutory representatives of the CZ-SK ECR Initiative).
Name:Position/Department:
Contact: / Tel: / E-mail:
Specialists nominated by company for active involvement into the projects and activities of working groups:
Future Supply Chain
Collaborative supply chain, Sustainable Transport, Shrinkage, OSA, Packaging, Pallet management,.. / Consumer/Shopper driven demand
Optimal assortment, Efficient promotions, Category management, Mobile Commerce / Enabling Technologies / Business Information
EDI, GDSN, Data quality, RFID EPC, GS1 Standards
Name:
Position/Department:
Tel:
E-mail:
Note:.…………………………………………………………………………………………………………………………………………..
……………………………………………………………………………………………………………………………………………………
Porozumienie ECR Polska, tel: +48 61850 4943, +48 61850 4981, fax: +48 61852 6376
Instytut Logistyki i Magazynowania,ul. Estkowskiego 6, 61-755 Poznań, NIP:777-00-20-410, REGON:000018603
Zarejestrowany pod nr KRS 0000052866 – Wydział VIII Gospodarczy Krajowego Rejestru Sądowego Poznań – Nowe Miasto i Wilda
Konto bankowe: Bank Zachodni WBK S.A., 6 O/Poznań nr 39 1090 1362 0000 0000 3601 7908