GPPA

CONTACT INFORMATION

* Denotes mandatory fields.

* Title:

* Full Name:

(Last Name)

(First Name)

* Office Phone:

Country Code	Area Code	Phone Number

* Mobile:

Country Code	Area Code	Phone Number

* Fax:

Country Code	Area Code	Phone Number

* Company Name:

* Company Address 1

Company Address 2

Mailing Address
(If different from above)

* Email:

GENERAL INFORMATION

* What is your Business Type:

* What products / services do you offer?

* Number of employees?

* Are you a member of any other industry association(s)?

Yes

If yes, please list:

MEMBERSHIP TYPE

* I am interested in:

becoming a founding member

becoming a member

becoming an associate member

attending the first General Assembly of the GPPA

being visited by a GPPA representative

receiving regular information

Others (please state)

DECLARATION

By completing this form and clicking on "Submit", I agree to have my information provided to be used for GPPA’s purposes only.

GPPA respects your privacy and values your goodwill. The personal data you have provided will be used for GPPA’s purposes only. This includes sending you email updates on events organised by the academy, or to remind you about application deadlines for GPPA awards and business.

For more information, please contact:

Gulf Plastics Pipe Academy
T. +971 2 6070 888 • F. +971 2 6070889 • P.O. Box 6951, Abu Dhabi, UAE
Email: robert.lawrence@borouge.com