Membership Application

Please fill-in the form below.

Membership Type :
Country * :

Name * :
Contact Name * :
Email * :
Mobile :
Tel :

Country code (ie. UK is +44) - area code - local number
Fax :
Address :
 
Zip Code :
Website :

To enhance contact in between IPTN members, you may like to offer accommodation to other members if they should come and visit your country.
Accommodation :

Please untick the following contact information if you do not wish to list on our website.
Contact Name :
Email :
Mobile :
Tel :
Fax :
Address :
Website :

Please select payment method.
Payment * :

If you choose Paypal / Credit Card payment, please read the following:
After you complete Paypal / Credit Card payment, Paypal will provide a transaction ID. Please come back and fill it in the following field.
click here and pay now.
Transaction ID :

For Paypal / Credit Card payment only