APPLICATION FOR CORPORATE MEMBERSHIP OF EUROPEAN MANUFACTURERS OF VETERINARY DIAGNOSTICS (EMVD)

 

 

We, the undersigned,
(Indicate first name and last name)

 

in our quality of

   

Acting on behalf of
(Company name and registered address)

 

 

Hereby apply for membership of EMVD

 

Done at                                                             on

 

Authorised signatures


 

MEMBER IDENTIFICATION FORM

 

 

1                  Name of the Company

 

 

2                  If existing, official abbreviation

 

 

3                  Legal form of incorporation

 

 

4                  Date of incorporation

 

 

5                  Nationality of the company

 

 

6                  Capital

 

 

7                  The company is a subsidiary/division of

 

 

8                  The company belongs to the group/holding of

 

 

9                  Company head office

 

                            Street address

 
                          Postal address
  
                       (if different)

                            Telephone                                                         Telefax

 

10            Name, postal address and telefax number of the person to whom EMVD general correspondence should be mailed

 

OTHER INFORMATION
(if available)

 

1                  PERSONNEL EMPLOYED BY THE COMPANY

              A.      Workers :  

              B.      Employees :
 

FIELDS OF ACTIVITIES
(Please tick as appropriate)  

 

                   O      Research and development                                                                           

 

                   O       Manufacturing                                                                           

 

                   O       Marketing    (Main countries where laboratories are established)