Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.1Applicant Details234Section A: Applicant Details Please provide your details below. Applicant Type *IndividualOrganisationMembership Category *Category A (CSA-Accredited)Category B (Honorary)Individual ApplicantFirst Name *Middle NameLast Name *CSA Accreditation Number *Title / Position *Contact Address *Email *Phone * Organisation Details Organisation Name *Organisation Type *Service ProviderEstablishmentAssociationNon-ProfitSector InstitutionOtherCSA License Number *Contact Address *WebsiteContact Person *Full NameEmail *Phone * Authorised Representative First Name *Middle NameLast Name *CSA Accreditation Certificate No. *Email *PhoneNextSupporting DocumentsAttach the documents required for your membership category.Category A – CSA-Accredited Valid CSA License / Accreditation Certificate *Endorsement Letter from a current Forum Member *CSA Professional Certificate *Category B – Honorary Statement of Qualification / Contribution to Cybersecurity * CSA Protection Category Endorsement Letter from Sponsoring Organisation *CSA Endorsement Letter *PreviousNextSection C: Declaration Please read and confirm each commitment below As a member of the Ghana Cybersecurity Industry Forum, I hereby declare and commit to the following: *I will actively participate in Forum activities and programmes.I will contribute to the development and growth of the cybersecurity industry in Ghana.I will uphold the Forum's Code of Ethics and professional standards.I will abide by the Forum's Constitution and By-Laws.I will represent my qualifications and credentials accurately.Data Protection Consent *I consent to the collection, processing, and storage of my personal data by the Forum for the purposes of membership administration, in accordance with the Data Protection Act, 2012 (Act 843) of Ghana. Signature Full Name *PreviousNextUpdating preview…This is a preview of your submission. It has not been submitted yet! Please take a moment to verify your information. You can also go back to make changes.PreviousSubmit