MEMBERSHIP TO ATU

Fill out the following application form, and we will get back to you. Please ensure you have read the Membership benefit statement, and had a look at our Membership Pack.

Entities and organisations are requested to send this from through any of the following bodies of the Member State to which they are responsible. For online applications, the related bodies shall be contactacted by ATU. Ministry responsible for telecommunications; Administration (Regulatory Authority) designed by the Government to discharge any obligations under the Constitution or Convention of the union. Secretary General, African Telecommunications Union. Regional organisations may send it direct to the ATU Secretary General.

Company/Organisation/Entity: --- Select --- Company Organisation Entity

Name:

Contact Person:

Title:

Physical Address:

P.O.Box: Tel: Email: Fax:

Wish to become an Associate Member of ATU under Classification Coporate - Large Coporate - Medium Coporate - Small

Indicate the Category of your Organisation Telecom Operators - Fixed Networks Telecom Operators - Mobile/Cellular Networks Internet Service Providers Radio/TV Broadcasters ICT(Information and Communicatiuon Technology) Manufacturers ICT Consultants and Contractors ICT Universities/Polytechnics/Colleges ICT Associations Other ICT Industrial/Scientific Organisations (Specify)

Annual Contribution 2000/2001 The contributory share of an Associate Member is based on the Member States Scale of contribution at the following rates: Corporate - Large: 1/2 of the Member States scale of contribution Corporate - Medium: 1/4 of the Member States scale of contribution Corporate - Small: 1/8 of the Member States scale of contribution The corresponding assessments are shown in the associated ATU scale of contributions for 2000/2001.

We, named below, have the power and authority to submit this application on behalf of our company/organisation. We undertake to adhere to the provisions of the Constitution and Convention of the Union in all respects.

Name: Title:

Name: Title:

Date: