EmailMe Form - Membership Subscription Form

Date *

DD / MM / YYYY

Name of Organisation

Contact Person *

First Last

Email *

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Telephone / Mobile Number *

Subscription Type *

New Subscription - Eur120 (Valid for 12 months from payment date)

Annual Renewal - Eur60 (applies only within 3 months from current expiry)

Payment

Bank Account Details

Bank Name: Bank of Valletta
IBAN number: MT14VALL22013000000040019986609
Swift Code: VALLMTMT

VAT Number

Payment Options *

Request for Tax Invoice and make Bank Transfer now

By LPO (For Government entities only - membership starts from date of purchase order)

Upload Proof of Payment (Screenshot of the Bank Transfer)
OR
Upload Proof of Purchase Order (Government Entities only) *

Declaration and Consent

CONTENT DECLARATION
By ticking the box below, I, hereby declare that the details furnished above are true and correct to the best of my knowledge and belief and I undertake to inform the Malta Competition and Consumer Affairs Authority of any changes therein, immediately. In case any of the above information is found to be false or untrue or misleading or misrepresenting, I am aware that I may be held liable for it.

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I agree with the content declaration

DATA PROTECTION STATEMENT

Personal information provided in this form is protected under the Data Protection Act (Chapter 440 of the Laws of Malta). The Malta Competition and Consumer Affairs Authority will process your personal data in accordance with the provisions of the Data Protection Act for licensing and administrative purposes and to comply with the Authority’s legal obligations. Upon approval of your application, the Authority, occasionally, may use your personal information.

DATA PROTECTION CONSENT *

I, hereby acknowledge that I have read, understood and agree to the above data protection statement.