Application Form For
Total Page：16
File Type：pdf, Size：1020Kb
APPLICATION FORM FOR TECHNICAL CORRESPONDENT MEMBERSHIP
COMPANY NAME:
ADDRESS:
MAIN ACTIVITY (please tick) Producer Consumer National Association Engineering contractor Equipment supplier Other (please specify):
CONTACT FOR EURO CHLOR:
Name:
Job title:
Telephone:
Fax:
Company website:
Company VAT:
Address (only if different from above)
-1- GRADE OF MEMBERSHIP APPLIED FOR (please tick)
Technical Correspondent
ADDITIONAL INFORMATION TO BE GIVEN
By chlorine producers:
Plant location Country Capacity Type of Cells(1) Year of (in tons) Start-up
1.
2.
3.
4.
(1) membrane, diaphragm, mercury, others
Areas of interest (please tick) Production Storage Transportation Other (please specify):
By chlorine consumers:
Area of activity:
Annual consumption (please tick) Less than 5000 tons/year From 5000 to 30000 tons/year Above 30000 tons/year
Type of chlorine storage (please tick) Drums/cylinders Iso-containers Rail cars or road tankers Fixed tanks Fixed spheres
-2- By equipment supplying companies (please complete):
General activities:
Types of equipment supplied to the chlorine industry:
By others (please complete):
Reasons for wishing to join Euro Chlor:
PLEASE RETURN THE COMPLETED FORM PREFERABLY BY E-MAIL (FAX OR MAIL IS ALSO ACCEPTABLE) TO: Euro Chlor Attn: Chantal Peeters Avenue E Van Nieuwenhuyse 4, Box 2 B-1160 Brussels, Belgium Email: [email protected] Fax: +32 2 676 72 41
-3-