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Membership Application Form

Membership Application Form

Please read "About personal information protection" before applying for membership (change). Please fill in the items below and click the submission button. Your information is protected by encrypted SSL (Secure Socket Layer).

I have read and agree to "Personal information protection"
(Required item)

Company name
(Required item)
Company name example: ABC Co., Ltd.
Company name (English)
(Required item)
Business overview

(Required item)
URL
URL (Overseas sites)
Postal code
Address
(Required item)

　Representative (division head or above)
Title
Name
Name example: Jane Smith
Name (English)

　Primary contact
Postal code
Address
(Required item)
Address (English)
(Required item)
Department
(Required item)
Name
(Required item)
Name example: Jane Smith
Name (English)
(Required item)
Telephone
(Required item)
Fax
Mail
(Required item)
Confirm mail address
(Required item)

Member category
(Required item)


We agree to CLPA promoting our company where possible (e.g. website, trade fairs, seminars, brochures, advertising, social media, etc.)
(Required item)

〔However, after products are developed and pass the conformance test, this will automatically be changed to 1. Please feel free to contact us if you have questions.〕
Reasons for joining

(Required item)		 〔Planning to develop etc.〕
Comments

For regular members and above.
　Engineering contact (If different from primary contact)
Postal code
Address
Department
Name
Name example: Jane Smith
Telephone
Fax
Mail
Confirm mail address

　 Billing address for annual fee ＊Please contact your local branch for payment details.・Automatic update system (Add if different from primary contact)
Company name
Company name example: ABC Co., Ltd.
Postal code
Address
Department
Name
Name example: Jane Smith
Telephone
Mail
Confirm mail address

　CC-Link Family compatible products (enter any devices scheduled for development)
Device type e.g. Sensors
Series and models
 If the item is a series, enter series name. If single devices, enter model names. e.g. GP series
Feature
Product sales situation ＊We promote conformance test certified products on the CLPA website and in our catalogs. After passing the conformance test, please fill in the product information from the Member Page.
Comments

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