Name of Company *Email (Contact Person) *Contact Person *Fax No.WebsiteDate *Head Office Address *Certificate of Incorporation/Registration No *International Affiliations (if any)Company’s products/servicesName of Chief Executive *Telephone No of Chief Executive *Email Address of Chief ExecutivePlease mark below which Sub-Group(s) you wish to belong:Internet Services Providers (ISP):a. Wholesale Segment - Registration Fee N500,000 - Annual Dues N500,000b. Retail Segment - Registration Fee N250,000 - Annual Dues N250,000Telephone Operators:a. PNL/Fixed Line Operators - Registration Fee N500,000 - Annual Dues N500,000b. MNOs/IDAs Operators - Registration Fee N1,000,000 - Annual Dues N1,000,000Over The Top (OTT) Players - Registration Fee N2,500,000 - Annual Dues N2,500,000FINTECH/e-Commerce Operators - Registration Fee N250,000 - Annual Dues N250,000Manufacturers - Registration Fee N1,000,000 - Annual Dues N1,000,000Consulting - Registration Fee N100,000 - Annual Dues N100,000Value Added Services Providers (VAS) - Registration Fee N200,000 - Annual Dues N200,000Equipment Dealers - Registration Fee N100,000 - Annual Dues N100,000Infrastructure Providers:a. Interconnect/Data Centre Operators - Registration Fee N250,000 - Annual Dues N250,000b. Towers/Base Stations Providers - Registration Fee N1,000,000 - Annual Dues N1,000,000Kindly make payment into the following: Bank Details Bank Name Guaranty Trust Bank Zenith Bank Plc Account Name Association of Telecomm. Companies of Nigeria Account Number 0000745342 1013343069 Sort Code 058152010 057150521 Branch Name The Plaza Agidingbi Register
