Membership Registration Form for the Board Club

This form cannot be submitted unless all required fields are completed *
Please read our terms and conditions below before applying.

Your Details

Do you have a FTM PIN?	Yes If yes, please insert FTM PIN
Title
First Name*
Surname*
Position*
Company Type*
Company Name *
Address *


Town *
Postcode *
Country *
Email *
Telephone *

Which market sectors do you serve? (Tick maximum of 3)

Job Function (Tick only 1)

Which technologies are you interested in? (Tick all applicable)

Where did you hear about the board you are applying for?

Trade Press Magazine Advert Date

Other

Terms and Conditions
Membership to the Board Club is subject to qualification. Future Electronics reserves the right to deny or cancel, without notice, any membership application or request for development boards. All Future Electronics Blox boards and third party development boards are offered subject to availability at the time of application. By applying for Board Club membership you are giving consent for Future Electronics and other Blox programme partners to contact you with offers that are deemed to be of interest to you. Your details will not be forwarded to any other companies.

Aerospace/Military	Lighting/Signs
Amusement/Leisure	Medical
Audio/Video	Metering
Automation	Motor Control
Automotive	POS/Vending
Broadcast	Power
Computing	Fire/Safety/Security
Consumer/White/Brown gds	Telecoms/Datacoms/Networking
Embedded Control	RF/Microwave
Industrial Control	Other
Instrumentation

Design	R&D
Production	Corp. Management
Purchasing	Tech. Management
Consultant	Other

Programmable Logic	Control ICs
MCU	Power Supply
MPU	AnalogueI/O
Memory	Passive, Emech, Interconnect
User Interface	RF
Digital I/O