Euro-IX Patrons

Patron application form

Please fill all fields of the following form.

	Important: a) I have read, understood and am in agreement with the Euro-IX Articles of Association Yes No
	b) I have read, am in agreement with and will adhere to the Euro-IX Patron's Code of Conduct Yes No

1.	Your organisation's name
2.	Website URL
3.	Your name
4.	Your phone number
5.	Your e-mail
	Leave fields 6, 7 & 8 empty if they are the same as above.
6.	Primary contact name
7.	Primary contact phone number
8.	Primary contact e-mail
9.	Invoice Address
10.	Purchase order number
11.	Invoice references
12.	VAT number (if applicable)
13.	What is your main motivation in becoming a Euro-IX Patron?
14.	For how long do you envisage being a Euro-IX Patron?
15.	How did you come to hear about the Euro-IX Patronage proposal?
16.	Comments/questions.