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Phone

This field is for validation purposes and should be left unchanged.

𝗡𝗮𝗮𝗺 𝗯𝗲𝗱𝗿𝗶𝗷𝗳/ 𝗼𝗻𝗱𝗲𝗿𝗻𝗲𝗺𝗶𝗻𝗴

Company Name

Business Address City ZIP / Postal Code

Mailing Address City ZIP / Postal Code

Phone number

Website

General email address

Billing email address

I do/do not give permission for our company information—consisting of company name, city, and website—to be included on the Fedecom website.(Required)

Well

None

Number of employees, including business owner(s) (anyone who contributes to the company’s revenue).(Required)

In FTE:(Required)

VAT number

Represented by

Function

E-mail address

Mobile number

Operations began on

Chamber of Commerce number

The company has permanent business premises and/or a permanent workshop

Yes

No

The company has filed its annual financial statements with the Chamber of Commerce or has an auditor’s report.

Yes

No

Gross annual revenue(Required)

The aforementioned company (the enterprise) has divided its activities among the sectors as follows:

% 𝗼𝗺𝘇𝗲𝘁 (𝘁𝗼𝘁𝗮𝗮𝗹 𝟭𝟬𝟬%):

Agricultural Technology

Livestock Farming Technology

Green Technology

Industry & Internal Transportation

In FTE:

Agricultural Technology

Livestock Farming Technology

Green Technology

Industry & Internal Transportation

General(Required)

Please note that we will process the personal data you provide to us when filling out this form—and any additional data you may provide in the future—in accordance with our privacy statement. You can find it here:fedecom

I agree to the processing of my personal data as described in the privacy statement

I hereby declare that I wish to become a member of Fedecom. The above-mentioned company (the “Company”) applying for membership is based in the Netherlands and declares that it meets the membership criteria as set forth in Fedecom articles of incorporation. The applicant also declares that they have reviewed the information regarding Fedecom membership and have accurately and completely filled out the required information on this application form.

This membership application will be processed upon receipt of the fully completed form.

Date

Name

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Fedecom Membership Application Form

Fedecom Membership