Corporate membership application

Supporting documents

PDF, JPEG, or PNG. Phone photos are resized automatically. Keep all documents together under 3.5 MB.

Company Registration Document (required)

Identification Document (Authorized Person) (required)

Company Profile (optional)

Relevant Licence/Regulatory Documentation (where applicable) (optional)

Additional documents requested by BAN (optional)

Declaration

I confirm that the information provided in this application is accurate and complete.

I understand that:

Submission of this application does not guarantee membership.
Membership is subject to review and approval by the Blockchain Association of Namibia.
Membership does not constitute a licence, regulatory approval, certification, or endorsement of the organisation’s activities.
Approved members are required to comply with the Association’s Constitution, Membership Agreement, and applicable policies.
Membership fees become payable upon approval and prior to activation.

I confirm the declaration above.

Name of Authorised Representative

First Name

Last Name

Position

Signature

Type your name, or draw in the box. Either counts as your signature.

Date

Membership is a subscription to a non-profit association. It does not involve buying, selling, trading, or holding any virtual asset, and it is not an investment product.