...Global Coverage, Local Solutions
4Home
4Join DGLN
4Quotation Service
4Contact DGLN
4Worldwide Members
4DGLN News
4DG Support Line
Members Only Area
Membership PRE-QUALIFICATION Questionnaire
Please do NOT use all capital letters
.
Application for:
(View Membership Types )
Full Membership - Exclusive
Full Membership - Regular
Associate Membership
Company Legal Name:
Other Names being used:
Contact Name:
Contact Job Title:
Address:
City:
State / Zip or Postcode:
Country:
Telephone:
Fax:
Email:
IM Address (if applicable):
Skype AIM MSNGoogleTalk
Website:
http://
Year Company established:
Branch Offices to be listed/enrolled (if in addition to Head Office listed above)
Average Annual Revenue during past 5 years:
US$
- of which % from DG:
Number of staff having DG Training:
(Part Timers, Consultants & Temps = 1/2)
- of which having > 10 years experience:
(Must be at least 1)
- of which having > 5-10 years experience:
Which Associations/Networks are you affiliated with?:
Are you licensed by any governmental authority?:
If YES, please provide details:
NO YES - Provide details
Is there a requirement to have your staff trained/certified in DG procedures by your trade association, govermental authorities, etc?
Do you have any lawsuits, insurance claims
or judgments outstanding against you?
NO YES - Explain
NO YES - Name the Insurance carrier and amount of coverage
Brief description of your company & its capabilities for
display in our "Members Only" section (Max 250 characters):
If another DGLN Member, please advise company name
to that we can give them the necessary credit:
