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 Membership Application

Please kindly fill out both pages of the following Application for Membership. The information will be used to present your request to the EFPA Board and then to the entire EFPA membership. If your request is approved, this information will be reproduced in the next EFPA Membership Directory.

Company information

Please kindly provide information in this section regarding the company which is requesting membership in EFPA (i.e. for whom an annual subscription of euro 5160 will be paid). Groups with European turnover > euro 100 million must pay euro 10320 and may nominate two companies to participate in EFPA (in this case please return two forms).

Company:
Address:
Code + City:
Country:
Telephone:
Fax:
E-mail:
Affiliation:
(Please note here any company affiliation you may have, e.g. subsidiary of a larger group.)

Main line of products

Please give us a brief overview of the products produced by your company and send us your latest company literature, annual report and/or brief product information.

I am sending you our latest company literature, annual report and/or brief product information.

Contact information

Please indicate below the person who will represent your company for EFPA purposes and to whom all EFPA correspondence will be sent.

Mr / Ms / Dr / Other:
First Name:
Family Name:
Address (if different from above):
Code + City:
Country:
Direct Tel:
Direct Fax:
E-mail:

* * * * *

Secretary / Alternative contact:
Address (if different from above):
Code + City:
Country:
Direct Tel:
Direct Fax:
E-mail: