MEMBERSHIP APPLICATION FORM

Company Information

Company name
Company address
Company URL

Primary Company Contact

Name
Title
E-mail
Mobile phone

Alternate Company Contact

Name
Title
E-mail
Mobile phone

Invoice Contact (if different than the main contact)

Name
Title
E-mail
Mobile phone
Invoicing address

PR / Communications Contact

Name
Title
E-mail
Mobile phone

Membership Level

Please indicate the membership level your company is applying for:

Advisory Membership
open to all organizations / 20,000€ / year
Full Membership
Open to (a) A bank holding a banking license OR (b) any other financial institution that is (i) licensed by OR (ii) authorized by OR (iii) registered with a Financial Market Regulator
AND
Is subject to supervision by a Financial Market Regulator OR (c) a manufacturer of mobile communication devices OR equipment OR (d) A mobile (Virtual) network operator OR (e) Operating system provide. / 10,000€ / year
Senior Associate Membership
Open to all organizations / 8,000€ / year
Associate Membership
Open to organizations with Employees < 50, AND Turnover ≤ € 10 m, AND
Balance sheet total ≤ € 10 m / 5,000€ / year

The above membership fees are subject to change.

Membership is continuous and invoiced on a yearly basis. As stated in Mobey Forum’s Articles of Association:

Member may resign as a Member at any time by giving 7 days’ notice and a sum of money equal to full payment of any and all fees and dues remaining unpaid on the date of resignation. Each annual membership begins as stated in the date of the membership application form. No refunds of any dues or fees shall be made in event of resignation.

For more information about the membership levels, please refer to Mobey Forum’s Articles of Association or the Operational Procedures document.

Payment Methods

There will be an invoice after Board approval. Please find Mobey Forum’s Bank details below for wire transfer

Bank Name: Nordea Bank IBAN FI 29 1200 3000 0251 71 SWIFT Code: NDEAFIHH

Credit card payment, please visit http://www.mobeyforum.org/Membership/Membership-payment

Signature

By signing this application, the Applicant acknowledges and agrees that the membership to Mobey Forum is subject to Mobey Forum’s Articles of Association and Standard Operations and Procedures. The membership is valid from the date the application form is signed. This application is subject to approval by Mobey Forum’s Board of Directors.

Please sign and print name Date and place (beginning of membership)

______

______

Director of applying company

Related Documents:

Standard Operations and Procedures

Articles of Association

Anti-trust Guidelines

Mobey Forum – Mobile Financial Services Ltd. Contact

Aleksis Kiven katu 3-5, VO4155

00500 Helsinki, Finland +358 50536713