GS1 Namibia Membership Subscription & Licence Application

Previous Membership with GS1 Namibia:

Yes No Unknown

Affiliation to current GS1 Namibia member:

Yes No Unknown

Company Name:

Company Registration Number:

VAT Registration Number:

Postal Address:

Suburb:

Province:

Postcode:

Physical Address:

Suburb:

Province:

Postcode:

Business Phone:

Business Fax:

Business E-mail:

Website:

GS1 Coordinator:

Title:

First Names:

Surname:

Position/Title Within the company:

Phone:

Cellular:

E-mail:

Accounts Department:

Title:

First Names:

Surname:

Position/Title Within the company:

Phone:

Cellular:

E-mail:

"Select Tranding Partners"

Partners:

Which of the following industry verticals do you work within (Please tick the appropriate box)? Education

Industry:

Mandatory documents to be submitted with this application form:

Company Registration/ID Document:
VAT Certificate:
Tax Clearance:

GS1 Namibia