Membership Form

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CYVA MEMBERSHIP FORM
1. Company Details
Company Name:*
Principal Activities:*
Registration No:*
Physical Address:*
Postal Code:*
City:*
Country:*
P.O. Box:
Postal Code:
City:
Tel:*
Fax:
Email:*
Website:
Contact Details if different from above:
Name:
First
Title:
Email:
2. CYVA Website Content
I confirm I would like to be listed on CYVA’s public members registry
3. General Data Protection Regulation (GDPR)
I consent to the recording, storage and use of my data by CYVA
I would like to receive information from CYVA
Data will only be used by CYVA. We will not, in any circumstances, share your personal information with any third parties without your permission.
4. Declaration
Name:*
First
Title:*
Date*
DD slash MM slash YYYY
I hereby confirm that I am duly authorised to submit this form for registration
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