Licensed Affiliate Organization (AO) Application

Licensed Affiliate Organization (AO) Application
Affiliate Company Name*
Physical Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
Website*
Affiliate Contact Person*

First NameLast Name
Contact E-mail
Who will be responsible for paying Axelos IPR fees?*
Who will be responsible for PeopleCert invoicing?*
Should be Empty: