Certicom ZigBee Smart Energy Device CA Subscriber Enrollment

ZigBee Alliance Info

ZigBee Manufacturer Code:
ZigBee Certification ID Number*:
ZigBee Alliance Membership Status:
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.

*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.

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.
Name:
Title:
Company:
Department:
Address 1:
Address 2:
City:
State / Province:
Zip / Postal Code:
Country:
Email Address:
Telephone:
Fax:

Technical Contact Information

The Technical Contact may or may not be the same person as the Primary Contact.
Name:
Title:
Email Address:
Telephone:

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.
Name:
Title:
Company:
Department:
Address 1:
Address 2:
City:
State / Province:
Zip / Postal Code:
Country:
Email Address:
[* Invoices will be emailed to the above address]
Telephone:
Fax:
DUNS Number:
Ship to name:
Ship to (email) address:

Information for Subscriber Agreement

Signatory

This is the person authorized will be signing the agreement on behalf of your company.
Name:
Title:
Registered Company Name:
Address 1:
Address 2:
City:
State / Province:
Zip / Postal Code:
Country:
Organized Under the Laws Of:
E.g. State of Delaware
You will need to provide your articles of incorporation, business license, or other suitable charter documents. Documents need to be delivered in English.
License Type: