Application for Associated Membership

Application for Associated Membership
Date of Application*

DayMonthYear
Company Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Country codePhone Number
Sector*

AccountingArchitecture/ DesignBankingConstructionFinanceFood and beveragesGovernmentalHealth careICTIndustry/ ProductionLawLogistics and transportMarketing/ Communication/ PRReal estateRecruitmentResearch and developmentRetailTradeOther
Turnover
Are you registered for VAT?*

YesNo
VAT Number
Website
Please indicate which Social Media platforms you and/or your company uses.*

FacebookLinkedInTwitterYouTubeInstagramNoneOther
Main Contact
Full Name*

TitleFirst NameLast Name
Job Title*
Direct Line

Country CodePhone Number
Email Address*
Please indicate your main language*

DutchEnglishFrench
Accounting Department
Email Address*
Membership Agreement
Associated Membership is for selected suppliers only who receive preferred supplier status, invitations to all events at discounted prices, our free electronic newsletter, free PR in our newsletter and social media channels and their logo on a dedicated page on our website.

Please note: Membership fees are for one year from date of invoice.

Membership Fee is £1100 + VAT
Please select the preferred type of payment*

Electronic bank transferCredit cardDirect Debit/ Domiciliëring/ Prélèvement Automatique
If Direct Debit, please select payment frequency.

One-off lump sumQuarterlyMonthly
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If you have any comments or questions, please submit them here:
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Application for Associated Membership

Main Contact

Accounting Department

Membership Agreement