ICPC Membership Application Form

Organisation Name

Class of Membership

Please refer to Section 2 of the Membership Agreement to determine the class of membership that your organisation is qualified to apply for, then select the relevant option below.

Status (Full Membership applications only)

Please refer to Section 1 of the Membership Agreement to determine the definition that describes the primary business of your organisation, then select the relevant option below.

Submarine Cable Details (Cable Owners, Science and Maintenance Authorities only)

Please list the cables and/or vessels that qualify your organisation for Full Membership of ICPC.

ICPC Representatives

Please supply details of the primary and alternate contact persons for your organisation below.

Primary Contact

Title

First Name

Middle Name

Last Name

Job Title

Preferred Phone No.

Email Address

Address

Alternate Contact

Title

First Name

Middle Name

Last Name

Job Title

Preferred Phone No.

Email Address

Address

Organisation Details

Telephone Number
Fax Number
Website Address
Invoice Address Town/City County/State Zip/Post Code Country VAT Number

(not applicable for selected Country)

Registrant Details

If the Registrant is not the Primary or Alternate contact above, please enter your details below.

Title

First Name

Middle Name

Last Name

Job Title

Preferred Phone No.

Email Address

Comments

If you have any comments or additional information regarding your Membership application to the ICPC, please enter them in the box below.

By ticking this box, you are agreeing with the ICPC GDPR compliant Privacy Notice. If you have any questions or concerns please email secretariat@iscpc.org.

International Cable Protection Committee

ICPC Membership Application Form