Application Form

Basic Information :
Company Name :
Country :		City :
PO Box :		Postal Code :
Telephone :
Fax :
E-Mail :
Web Address :

Name of Chief Executive  :
Barcode Contact Person :
Title :
Company Legal Status :
Business Activity : Type of Activity (you may choose more than one) Manufacturing Retail Wholesale  Import Export Servicces Business Sector (you may choose more than one) : Food &  Beverages        Tobacco & Cigarettes Machinery & Equipment Pharmaceuticals & Cosmetics  Plastic Products  Electric Appliances Chemicals           Metal Products Construction Materials Household & toiletries   Paper & Carton  Packing & Packaging Textiles & Apparel    Furniture & Stationary Newspapers, Magazines &Publications Public/Government Org.      Hotels & Restaurants Banks & Financial Institutions Transport & Communications Services Institutions

Please describe your activity :

Barcode Type :
EAN Company Prefix :	EAN-13	EAN-8
UCC Company Prefix :	UPC-A	UPC-E
In order to assign the appropriate EAN/UCC Company Prefix, we must understand how many total products do you have that vary in size, color, weight,...etc.  Products

Your EAN Company Prefix and Introduction to EAN numbering and barcoding will be sent to you upon receipt of your completed application form and registration fees.

The EAN Company Prefix allocated to your company is exclusively for your use, you must not assign, license or allow its use by any other company.

Your membership will be terminated if your account is not paid each year or if you do not abide by EAN.UCC specifications.

I hereby certify that the information contained on this application form is correct.