Membership Signup Company name Corporate email Website Registered address Postal code City Country Poland Afghanistan Albania Algeria Andorra Angola Antigua & Deps Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bhutan Bolivia Bosnia Herzegovina Botswana Brazil Brunei Bulgaria Burkina Burundi Cambodia Cameroon Canada Cape Verde Central African Rep Chad Chile China Colombia Comoros Congo Congo {Democratic Rep} Costa Rica Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France Gabon Gambia Georgia Germany Ghana Greece Grenada Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hungary Iceland India Indonesia Iran Iraq Ireland {Republic} Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea North Korea South Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Montenegro Morocco Mozambique Myanmar, {Burma} Namibia Nauru Nepal Netherlands New Zealand Nicaragua Niger Nigeria Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Qatar Romania Russian Federation Rwanda St Kitts & Nevis St Lucia Saint Vincent & the Grenadines Samoa San Marino Sao Tome & Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Sudan Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tonga Trinidad & Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Yemen Zambia Zimbabwe NIP Number KRS Number REGON Number In connection with which he declares that his annual income is 0 - 14.990.000zł 15.000.000zł - 29.999.000zł 30.000.000zł - 49.999.000zł 50.000.000zł + First Name and last name Position Email Phone number The declarant wishes to join the Association as: Supporting Member Partner I agree to the processing of my personal data contained in this declaration by the Association Cloud Community Europe Poland to the extent necessary to be its member and its activities (in accordance with the Act of 29.08.1997 on the Protection of Personal Data; consolidated text: Journal of Laws of 2002. No. 101, item 926 as amended). I have been informed that at any time I have the right to inspect and change my data, as well as delete it from the database. I agree to receive electronically commercial information about new products and services from Association Cloud Community Europe Poland (in accordance with the Act of 18.07.2002 on Provision of Services by Electronic Means, Journal of Laws of 2002. No. 144, item 1204). I have been informed that at any time I have the right to revoke my consent. The declarant undertakes to pay an entry fee of PLN 200. The declarant wishes to join the Association and therefore declares that he is ready to pay the membership fee to the account: Cloud Community Europe Polska MBank 93 1140 1010 0000 5757 8000 1001 Send