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MEMBERSHIP CENTER

SERVICE CENTER

Business Opportunity

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WORK CENTER

COMMS CENTER

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Methodology

SITE CENTER

[?] What is RSS

Step 2 - Complete Service Provider Form

Thank you for your payment. Your transaction has been completed, and a receipt for your subscription has been emailed to you. You may log into your account at www.paypal.com/nz to view details of this transaction.

Important: Please Now Complete the Form Below - to Complete Your Enrollment as a Service Provider. After completing the form you will receive an email with the details of Step 3 explaining how to access your profile set-up page. You may do this at anytime, however, it is advisable to do so quickly as you don't want to miss any opportunities.

After this you will receive details of your triple security single sign-on access to the Work Center and all the virtual consulting tools awaiting you. Please be patient on this as each system has to be set-up especially for you - typically 3-7 days.

More details at Step 3 .... See Your there.

Service Provider Membership Form

Please note that all fields followed by an asterisk must be filled in.

Name of Company, Group or Organization*
Name of Company, Group or Organization*

I have selected and paid for:*
I have selected and paid for:*

Please provide a brief description of your services... *
Please provide a brief description of your services... *

How many e-service experts work in your organization? *
How many e-service experts work in your organization? *

	Just Me
	2 to 5
	6 to 10
	11 to 100
	100+
	Rather Not Say

First Name*
First Name*

Last Name*
Last Name*

E-mail Address*
E-mail Address*

Web Site URL

Street Address*
Street Address*

City*
City*

State/Prov

Zip/Postal Code

Country*
Country*

Business Phone*
Business Phone*

What type of consultancy are you looking to offer?
Tick as Many as You think are Appropriate*
What type of consultancy are you looking to offer?
Tick as Many as You think are Appropriate*

	Business Mentoring
	Technical Mentoring
	Business Training
	Technical Training
	Project Management
	Research
	Business Analysis
	Strategy Development
	Product Knowledge
	Service Knowledge
	Quality Assurance
	Development
	Customization
	Benchmarking
	Change Management
	Tools & Methods
	Other e-service related

If Other please decribe briefly

What e-service areas does your service relate to?
Tick as Many as You think are Appropriate*
What e-service areas does your service relate to?
Tick as Many as You think are Appropriate*

	Specialist Technologies, e.g.RFID
	e-Learning products/services
	e-Health products/services
	e-Commerce or e-Business solutions
	e-Government products/services
	e-Cities & Municipal Control
	e-Transport Products/Services
	e-Charities & Non Profit Orgs.
	Location Based Services
	Mash Up Development
	Enterprise Architecture
	Back-End Systems
	Middleware
	Front-End Channels, e.g Portals
	Innovation or R&D
	Other

If Other please describe briefly.

Name, Position and email of Main Contact Point for Service*
Name, Position and email of Main Contact Point for Service*

Name, Position and email contact of Adminsitrator for Site Input *
Name, Position and email contact of Adminsitrator for Site Input *

Please enter the word that you see below.

Finished Step 2...Go To Step 3