Certicom ZigBee Smart Energy Device CA Subscriber Enrollment

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ZigBee Alliance Info

*Items in bold are required fields.

There are errors in the form below.

ZigBee Manufacturer Code

*If you do not know your company's ZigBee Alliance Manufacturer Code or need one assigned, please contact the ZigBee Alliance. Certificates can only be issued to ZigBee Alliance manufacturers with ZigBee Smart Energy certified products.

ZigBee Certification ID Number*

*If you do not know your product's ZigBee Certification ID# please contact the ZigBee Alliance. If your certification is pending, please provide an expected date and the test house you are working with.

ZigBee Alliance Membership Status

Primary Admin Contact Information

The Primary Contact is responsible for the operation of your device manufacturing system and is also authorized to request Administrative Certificates for your organization. Administrative certificates are used to sign Device Certificate or requests prior as part of the ordering process.

First Name

Last Name

Company

Title

Department

Address 1

Address 2

City

State/Province

Country

ZIP/Postal Code

E-mail Address

Phone Number

Fax

Technical Contact Information

The Technical Contact may or may not be the same person as the Primary Contact.

First Name

Last Name

Title

Phone Number

E-mail Address

Billing Contact Information

This is the person responsible for payment and notifying Certicom of any billing changes, for example an accounts payable representative. This may also be the same as your primary contact.

First Name

Last Name

Company

Title

Department

Address 1

Address 2

City

State/Province

Country

ZIP/Postal Code

E-mail Address

Phone Number

Fax

DUNS Number

Shipping Recipient Name

Shipping Recipient Email

Information For Subscriber Agreement

Signatory

This is the person authorized will be signing the agreement on behalf of your company.

First Name

Last Name

Registered Company Name

Title

Address 1

Address 2

City

State/Province

Country

ZIP/Postal Code

Organized Under the Laws Of

License Type

You will need to provide your articles of incorporation, business license, or other suitable charter documents. Documents need to be delivered in English.

By completing this form you agree to BlackBerry processing your personal data for the purpose of enrolling you or your organization as a subscriber.