The Institute of Telecom Resellers

WE INVEST IN PEOPLE. SHOW YOUR
INDUSTRY THAT YOU ARE A LEADER

WE LOOK FORWARD TO WORKING TOGETHER WITH YOU AND HELPING
YOU WITH YOUR CAREER.

REACH THE TELECOM DECISION MAKERS WHO PURCHASE
YOUR PRODUCTS AND SERVICES

IINSTITUTE OF TELECOM RESELLERS EMeIAAA. Europe, Middle East, India Africa, Asia and the Americas JOIN US !!!

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AFFILIATE APPLICATION FORM
(Yearly Membership subscription: Free of Charge
If this is not the level you wish to have please click Here )

Important: All Information given will be held strictly confidential by our administration and will under no circumstance be given to any 3rd party or used for any purpose other than to contact you regarding your membership

First Name
Last Name
Title: Mr. Mrs. Ms. Dr. etc
Number and Street
Address (cont.)
City
State/Province/ County
Zip/Postal Code
Country
Home Phone
Home E-mail
Home FAX
Name of Present Employer ( Will not be contacted, unless they are your sponsors)
Work Phone
Work E-mail
Date of Birth
Gender	Male Female
Level of membership required