Membership Application Form

Wireless World Research Forum (WWRF)

The Wireless World Research Forum (WWRF) is open to all interested parties. To become a member of the forum, please complete this form carefully. The completed and signed form should be sent to the secretariat of WWRF. The applicant (Individual or organization) will become a WWRF Member on acceptance of the application by the WWRF General Assembly,

Four different member categories are available. The annualmembership fee is payable as per the calendar year. It amounts to 100 Euro for Individual Members. For organizational members, it is 250 Euro for Associate Members, 1000 Euro for Full Members and 10 000 Euro for Sponsor Members. Please refer to notes 1, 2 and 3 at the end of this page.

Meeting participation costs will be additional to the membership fee. More information will be given in connection to every meeting.

Please note: the application form includes a short written statement identifying the applicant describing its interest in participating in the WWRF.

Name of Applicant – Individual[1]or Organization:[2], 3

Please specify what kind of WWRF membership is intended.

Individual Member Associate Member

Full Member Sponsor Member

Calendar year of membership applied for:

(Please fill in year at the beginning of which membership will commence, e.g., 2017)

Release of name:

Upon becoming a Member of the WWRF, the Applicant (Individual or Organization) agrees that the WWRF may, in connection with the membership, and so long as the Applicant is a Member, publish the applicant's name, the Membership status and the date on which the Applicant became a Member.

Website address to appear in WWRF membership listing and applicant’s(individual or organization’s) homepage, if any:

Declaration:

I, / Name

as a qualified individual or an authorized person of the Applicant Organization mentioned above, hereby apply for membership of the Wireless World Research Forum (WWRF), and further declare that the Applicant:

-Agrees to respect all legal provisions and statutes concerning the WWRF as described in the Articles of Association – the document originally signed on August 14th,2001 and modified there after as indicated on the title page of the version available on the WWRF homepage:

-or its representative(s) named overleaf shall be the official contact person(s) for receiving formal notices, voting papers, and invoices,

-shall become a member of the WWRFupon payment of membership feesafter the acceptance of this application by the General Assembly.

Please send the application form to the WWRF Secretariat (Further details are available on page 4). An invoice for the annual membership fee will be sent to you after approval of the membership application.

Signature:
Name in Full:
Position:
Date / Place: / Company stamp:

Designated Representative (Voting Contact):

Please fill in all the fields below.

First Name
Last Name
Company
Title
Address
City
State
Country
Postal Code or ZIP
Telephone
Fax
E-mail

Billing Contact (To be filled in if different from the Designated Representative)

Please fill in all the fields below.

First Name
Last Name
Company
Title
Address
City
State
Country
Postal Code or ZIP
Telephone
Fax
E-mail
Description of Applicant (Individual or Organization):
Reasons for the Applicant to apply for WWRF membership:

Please mail a pdf copy of the application form(s) to WWRF Secretariat:

Email:

WWRF secretariat contact person:

Name, Last Name / Dr. Vinod Kumar
Postal Address / 15, rue Poliveau
75005, Paris
France
E-mail /
Telephone (cell) / + 33 6 11 18 16 22

______

The Article of Association for WWRF can be requested through the secretariat contact person or downloaded from the WWRF homepage on Internet:

Page 1 of 4

[1] Individual membership is available for qualified individuals. For further details, please refer to article 4.2 of WWRF Articles of Association.

2. Only Small and Medium Enterprises (SMEs) are eligible for Associate Membership. Please refer to EC definition of SMEs for further details.

3 Please note that one membership may be used to represent multiple-affilliate companies within a group.