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Owner Identifier Registration Form

Please complete the following registration form and submit electronically to GCA. Then print the completed form and submit the hardcopy with payment to GCA.

Registration Fee: $95 US, GCA members $75 US

Company Information

Primary Contact:

Name:

Title:

Company/Institution:

Address:

City:

State/Province:

Postal Code:

Country:

Phone:

Fax:

E-mail:

Secondary Contact:

Name:

Title:

Company/Institution:

Address:

City:

State/Province:

Postal Code:

Country:

Phone:

Fax:

E-mail:

Description:

1. Please provide the text and URL for the first link (perhaps to your home page).

2. Please provide the text and URL for the second link (perhaps to a list of public texts with their formal public identifiers and links to the texts themselves).

3. Please provide the text and URL for the third link (perhaps to a form ordering a public text).

Payment Information

Please complete the payment information below. If you are concerned about the security of the server please submit the finished application electronically and then fill in the payment information and submit the hardcopy of the completed form to:

GCA / PTI Owner Registration

100 Daingerfield Road

Alexandria, VA 22314-2888

or fax to: +1 (703) 548-2867

Please indicate type of payment below:

Check or credit card number and expiration date

Authorized Signature / Name on Card

Return to the GCA Registry of Owner Identifiers

Return to GCA home page