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Which location/area are you applying for? *

About You

Full legal name of Company *
Registered Name (if different)

Type of Legal Entity *
Registration No. and Date *

Registered With
Start Up Date (dd/mm/yyyy)

Full Address of Head Office
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Country

Phone Number *
Fax Number

Email *
Website *

Name of Principal shareholders *

How did you learn about the WBN?

Recommendation from another member if yes, who?   Invitation from the network HQ Internet Search Engine

Is the company that applies for a membership a subsidiary or sister company or another company?

YesNo

If so, please name the company

Names of Principle Shareholders, Individuals or Companies

Does your company belong to any trade organisations, body or group (e.g. IATA/IPATA/ATA)? (Preferred but not essential)

YesNo

If so, state names(s)

Please ensure that you send copies of Professional Liability Insurance, IATA, and Customs Brokers licences to us, either by email immediately after submission of this form, or by fax on (0) 1252 781455.

Are you members of any other freight networks? If so, which one(s)?

Do you have branch offices? If yes, please provide full contact details?

Your confirmation that you agree to send a nominated representative to the first annual meeting of your membership

Yes No

For EU Member countries only - please provide your EU VAT number for invoice purposes

Name of person completing this form *
Position

IMPORTANT - PLEASE READ THE FOLLOWING DECLARATION CAREFULLY
I declare that I am the above named person and have full authority to apply for membership of the WBN. I confirm that I have read and will comply fully with the WBN Charter, Code of Conduct and terms of membership, as published on the WBN website.  

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