Your Details Your Name Your Email Your Company Details Company Name Company Address Please provide a brief summary of what service your Company provides. If your Company operates as a third-party provider obtaining financial data, please specify by which method you obtain that data Your Key Contacts (please note all email addresses provided will be added to our membership distribution list unless otherwise advised) Membership Invoicing Chief Executive Officer Technical Policy Website Others FDATA has built outstanding relationships with key players in governments and the regulatory, financial services and fintech sectors worldwide. Our ability to convince stakeholders that we are experts in our field and guardians of the highest possible standards of security and ethics is vital and central to our success. Have either you or your Company, or any Directors of your Company, even been subject to any regulatory or criminal action which could jeopardise that reputation? YesNo If yes, please give details in a covering email Membership Fees Do you need to provide FDATA with a purchase order number? YesNo If yes, please provide an email address: Please indicate the frequency of FDATA invoices you would prefer: AnnuallyQuarterly Do you give FDATA permission to add your logo to its website? YesNo If yes, please forward your logo with this completed application form. Which FDATA Chapter(s) do you wish to join and how many employees do you have in that territory? Europe ---1-9 (1)10-19 (2)20-49 (3)50-99 (4)100-249 (5)250-499 (6)500+ (7) North America ---1-9 (1)10-19 (2)20-49 (3)50-99 (4)100-249 (5)250-499 (6)500+ (7) South America ---1-9 (1)10-19 (2)20-49 (3)50-99 (4)100-249 (5)250-499 (6)500+ (7) Australasia ---1-9 (1)10-19 (2)20-49 (3)50-99 (4)100-249 (5)250-499 (6)500+ (7) Asia ---1-9 (1)10-19 (2)20-49 (3)50-99 (4)100-249 (5)250-499 (6)500+ (7) Africa ---1-9 (1)10-19 (2)20-49 (3)50-99 (4)100-249 (5)250-499 (6)500+ (7)