European Software Association - EUROPEAN SOFTWARE ASSOCIATION MEMBERSHIP APPLICATION FORM

EUROPEAN SOFTWARE ASSOCIATION MEMBERSHIP APPLICATION FORM

(Voting Full Member)

COMPANY

Company Name

Address 1

Address 2

City/Town

Postal Code

Website Address

Company Worldwide Revenues

In Million € (of last fiscal year):

Annual Membership Dues

ISV revenue is > €1.000M/year € 50.000
ISV revenue is > € 200M/year € 20.000
ISV revenue is > € 50M/year € 10.000
ISV revenue is > € 10M/year € 5.000
ISV revenue is < € 10M/year € 2.500

VAT Number

Product Description

Creation and publication of commercial software packages which are marketed directly or indirectly under its own name:

Total number of FTEs in Europe

Confirm that the Company has a research and development facility in Europe: (Please state countries and indicate per facility the FTEs that are part of the facility)

If yes,

Country	FTEs

Work Group Participation

I’d like to participate in a Workgroup

PLEASE INDICATE YOUR COMPANY’S BUSINESS AREA(‘S) BELOW:
HORIZONTAL APPLICATIONS
TYPE	TICK
Accountancy
Application Infrastructure
CAD / CAM
Content Management
CRM
Document Management
E-commerce
E-procurement
ERP
Human Resources
Mobility
Portals
Security
Supply Chain Management
Others
Others Specify

VERTICAL APPLICATIONS
TYPE	TICK
Automotive
Banking / Finance / Insurance
Education
Engineering / Construction
Healthcare
Hospitality / Leisure
Legal
Manufacturing
Media / Information / Publishing
Pharmaceutical
Public Sector
Retail
Telecoms
Transport / Logistics
Utilities
Other Verticals
Others Specify

REGISTRING AND SIGNING INDIVIDUAL (CEO)
Title: (Mr/Mrs/Dr)
First Name
Last Name
Job Title
Email Address
Telephone
Fax
Assistant First Name
Assistant Last Name
Assistant Email Address
Assistant Telephone
Assistant Fax