Declaration of Admission  

Friend: Educator, Advocate of the DAISY Consortium



Please provide (type) the information requested below and email to: 
join@daisy.org



Original name of your organization / company:



________________________________________________________________



Name of your company / organization in English:



________________________________________________________________



Please give a brief description of your organization's activities, in English:



________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________



Our company is a (please mark one):



__ for-profit organization        __ non-profit organization 



Address:



________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________



Phone:   		__________________________________



Fax:  			__________________________________ 

	

General E-mail: 	__________________________________ 



Website:  		__________________________________ 

	

Last and first name of the authorized representative: 



			__________________________________ 

	

E-mail: 	__________________________________ 



Last and first name of second contact: 



			__________________________________ 



E-mail: 	__________________________________ 



As the authorized representative of



	______________________________________________



I hereby declare that I have taken cognisance of the Articles of Association of the DAISY Consortium and accept the Regulations relating to Friends of the DAISY Consortium in all respects.

 

 

Friend: Educator, Advocate of the DAISY Consortium



Signed: 		__________________________________





(Name, typed) 	__________________________________





Date: 			_________