ATiS Membership Application Form

Membership Type*

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Member Particulars

Name*

Registered Business Address*

Origin Country of Business Registration

Applicant Nationality

Company UEN Number (Corporate Members)

Billing Address (for Receipt / Invoice)

Telephone / Mobile Number*

Correspondance Email*

Website URL

Authorised Representative Particulars

(For Corporate Members or Associate Member - Firms Only)

1 - Authorised Representative Name

1 - Authorised Representative Designation

1 - Authorised Representative Email

1 - Authorised Representative Mobile Number

2 - Authorised Representative Name

2 - Authorised Representative Designation

2 - Authorised Representative Email

2 - Authorised Representative Mobile Number

Main Business Activities - Business / Organisations*

Related Companies

Name of Parent Company

Country of Parent Company

Name of Subsidiary / Associate Company

Country of Subsidiary / Associate Company

Membership Fees*

First Year

Entrance Fee

First Year Pro-Rata Annual Fees (Month of Joining)

Corporate

(Entrance Fee + Joining Month)

Associate - Firm

(Entrance Fee + Joining Month)

Associate - Individual

(Entrance Fee + Joining Month)

Student

(Entrance Fee + Joining Month)

Payment Method

Internet Banking

DBS Bank Limited

Branch Code: 012

Bank Code: 7171

SWIFT Code: DBSSSGSG

All banking service charges to be paid by the sender

10 Anson Road 
#27-15 International Plaza, 
Singapore 079903 

©2019 ASSOCIATION OF THE TELECOMMUNICATIONS INDUSTRY OF SINGAPORE