Pacific Islands Telecommunication Association

Membership Application Form

Organisation Name:

URL:

Registered Office Physical Address:

Country:

Postal Address:

Required Information of Organisation

Telecommunications Carrier, Operator

Government Department

Vendor/Supplier

Main Activities/ Products/Services

No. of employees:

Chief Executive Officer

Name:

Job Title:

Main Contact Person

Name:

Position/Job Title:

Telephone:

Mobile:

* Please enter the Telephone and Mobile number without your country code.

Email:

Fees

A one-time joining Fee is to be effective from 01.01.2020

With less than 100 employees = same as annual subscription fee below
Above 100 but less than 1,000 employees = F$5,000
Above 1,000 employees = $10,000

Thereafter the Annual Subscription fees are:

Full Members = F$2,800.00
Associate members =F$2,500
Government Dept Member = F$500.00

I understand that upon payment of joining fee, membership will be provisional to be ratified at the PITA AGM. Thereafter I agree to be invoiced annually on due date to renew membership until I submit a membership cancellation in writing, one month or earlier prior to due date.