Application form for PUBLIC SAFETY MEMBERSHIP for PROJECT MESA

Please note that your organization becomes a Public Safety Member of Project MESA following the validation of your application by the MESA Organizational Partners.

If you experience any difficulties in submitting this form, please send an e-mail to mesa@projectmesa.org

ORGANIZATION NAME

ADDRESS

ZIP/POSTAL CODE

TOWN

COUNTRY

URL

Please indicate your PRINCIPAL ACTIVITY:

Please indicate below which ORGANIZATIONAL PARTNER you wish to designate as your Principal OP* (check one)

ETSI TIA

* A Principal OP is the standards development organization with which your company wishes to be affiliated for purposes of participating in project MESA. In choosing the OP, a Public Safety Member agrees to have its membership in MESA associated with that particular OP.

CONTACT INFORMATION

The "Principal Contact" will be used by Project MESA and its OPs for purposes of any general information.

PRINCIPAL CONTACT

TITLE

NAME

ADDRESS (if different from above)

PHONE

MOBILE

FAX

E-MAIL

OTHER CONTACT

TITLE

NAME

ADDRESS (if different from above)

PHONE