Application for RENAM membership

bd. Stefan cel Mare,168, oficiul 314
MD — 2004, Chisinau Moldova (Rep.)
Tel: (37322) 24-80-97, 49-70-22, 73-87-63
Fax: (37322) 72-70-26, 49-70-22

Application

for RENAM membership

We apply for membership as an ordinary member of the Research and Educational Networking Association of Moldova (RENAM) in accordance with the Association statutes requirements.
(name of organisation)
 
 
(adress)

representing the research and educational network in:

(organization/institution denomination)

We appoint as our delegate to RENAM Council:

(name of delegate)
(e-mail)
(phone, fax)

and as technical contact person

(name of technical contact person)
(e-mail)
(phone, fax)

We have taken notice of the current statutes of RENAM and accept our obligations as a member of the Association. Signed:

(date, signature)