To : iVDR Consortium 
  e-mail:info@ivdr.org 

           " Application Form of iVDR Specifications"
           ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
   Date:
   
   Company:

   Country:

   Representative (name):
      
   Contact Name:  Mr. / Ms. / (           )

   Position:

   Department:

   Full mailing Address:

   Phone:

   Fax:

   E-mail:

   Company website:
            English	http://
            Japanese	http://
      
   Established   Month:         Date:         Year:          

   Number of Employee:

   Capital stock:

   Business Summary:

   Primary Product or Service:

   Parent Company Name (if any):

   Primary Customer:

[iVDR000105628A012]