Request-ODVA-Agreement ODVA Agreements must be signed by an individual who is authorized to enter into Agreements on behalf of your organization. ODVA Agreements will be sent to your designated signer for electronic completion via SignNow. Step 1. Complete Applicant Information in EnglishPlease provide the name and email of the individual who is authorized to enter into the Agreement(s) on behalf of the Company Named provided below. Please complete ODVA forms and subsequent legal Application and Agreement in English. Name* Given Name Family Name Job TitlePosition held within your company1A: Company Name (Public-facing name)*Business name / Tradename of Entity to be displayed at 222.odva.org and other public lists of ODVA. 1B: Corporate Legal Name of Entity*Corporate legal name, as filed with Entity's articles of incorporation, certificate of formation, or other governing corporate documents. 1B.1: Country of Corporate Legal Entity*2. Which level of ODVA Membership are you seeking?* Regular (voting) Associate (non-voting, eligibility limited to entities whose employees for itself, its parent company, and all affiliates combined total fewer than 100 employees) Principal (voting; requires Board of Directors approval) Non-Member (Licensed Vendor, not eligible for membership privileges or discounts) Please contact me to discuss membership options 2a. Total Number of Employees of Entity, its Parent Company, and all Affiliates combined* 99 employees or fewer 100 employees or more 2b. Associate Membership Not Available; Regular Membership Applies* Regular (voting) Your company qualifies for the membership level Regular (Voting). Your company does not qualify for the Associate level of ODVA Membership due to the total number of employees.3. ODVA Technology to which entity seeks to become a Licensed VendorCheck the technologies that you wish to license now and in the future. EtherNet/IP, CIP Safety on EtherNet/IP DeviceNet, CIP Safety on DeviceNet CompoNet ControlNet CIP Safety on SERCOS III 4. Does you company already have a Vendor ID issued from ODVA? Yes No 4a. Vendor ID5. Email (work email address -- requests from personal email accounts will not be accepted.)*The Application and Agreement will be sent to this email address for completion. 5a. Do you need ODVA to send the application to a second person within your organization for signature?* No. I will complete and sign the agreement. Yes. I will complete the agreement, but I need to have someone else sign the agreement. Name of Authorized Signer Given Name Family Name Job Title of Authorized SignerPosition held within your companyEmail of Authorized Signer*The agreement will be sent to this email address for signing. 6. Comment By submitting this form, you agree to receive electronic communications from ODVA. To stop receiving communications from ODVA, please contact [email protected]. Δ
