PDEC membership application — Personal Data Ecosystem Consortium

Name of your organization:*
Company Headquarters Address:*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Headquarters Phone Number:*
Fax:
Website
Name of Primary contact person*
First Last
Email of primary contact person:*
Phone of primary contact person:*
Check here if primary billing is same as primary contact
- Check here if primary billing is same as primary contact
Name of primary billing contact:
First Last
Email of primary billing contact:
Phone of primary billing contact:

Income / Revenue / Budget of organisation / Department / Business Units	Standard Annual Fees Excl. Taxes
Over $10,000,000	$25000
Upto $10,000,000	$9500
Upto $1,000,000	$6000
Up to $250,000	$1000
Entreprenuer / Individual	$150

Send Your Check

Payable to:	Personal Data Ecosystem Consortium

Mail to:	Personal Data Ecosystem Consortium c/o: Financial Framework LLP PO Box 165 Arlington, MA 02476 United States

Membership application