Membership Application Form

Company information

Information about your company and its incorporation status
Company name*
Company legal name*
Parent company
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Main phone number*

Country codeArea codePhone number
Corporate ID type*

US Employer ID Number (EIN)US Taxpayer ID Number (TIN)UK Companies HouseCanadian GST/HSTEU VATOther
Corporate ID number*
Primary business type*

AgencyAdvertiserAd techPublisherOther
Primary website*
Other websites
Date of incorporation*

MonthDayYear
Date
Country of incorporation*
State of incorporation
For US corporations only
TAG Compliance Officer contact information
Click here to download the Compliance Officer Role Description
Name*
Work email*
example@example.com
Phone number*

Country codeArea codePhone number
Compliance Officer location*

The TAG Compliance Officer is located in the European Economic Area (EEA)The TAG Compliance Officer is NOT located in the European Economic Area (EEA)
Attestation

By checking the box below, you, as an individual, attest that you have the authority to submit this application on behalf of your Company and that the information provided is true and correct.
Acknowledgment*

I acknowledge the above.
Should be Empty:

Company information