Bolero Association Ltd and
Bolero International Ltd

Enrolment Application

Please follow the instructions in this form and the Enrolment Guide to assist you in completing this form. The enrolment guide is available to download from http://www.boleroassociation.org/enrol.htm

Part 1: User Information

Please fill out the form below with information about your company. Note: The information that you provide must be accurate.

Information to be certified:

The company signing in Box A below hereby requests Bolero International Limited to issue a certificate based on the following information:

Name of your company

Registration number of your company
(If registration numbers are issued in your jurisdiction)

In which country, state, or province is your company incorporated?

Company telephone number (Please include the international dialling code)

Company Fax number

Registered address of your company




Please enter the name and company title of the person(s) authorised to sign Box A on behalf of your company. (That person(s) is termed the Primary Representative(s).)

Name:

Title:

E-mail address:

Please complete this information if your company requires two persons to act as Primary Representatives.

Name:

Title:

E-mail address:

Which interface software will you be using to access the Bolero System?

Contact Name details:
If the form is completed on behalf of the Primary Representative, this information lets us know who to contact if we have questions. We do not disclose this information except within the Bolero Association and Bolero International.

Name:

Department:

E-mail address:

Telephone number (Please include the international dialling code)

Part 2: RID selection and Certification

Please enter your chosen Root RID below

Certification:

Please tick the box if you require dual certificate authorisation (separate certificates for the Business and Security administrators). Single authorisation will be assumed if you do not tick the box.

Note: You will also need to send an electronic copy of the certificate request(s) to the following e-mail address enrolment@bolero.net

Please cut and paste the PKCS#10 (the certificate request) into the area below:

Please cut and paste the corresponding SHA-1 into the area below:

Please cut and paste the second PKCS#10 (the certificate request) into the area below (only if you have selected dual authorisation).

Please cut and paste the corresponding SHA-1 into the area below:

Part 3: Signing

Having completed parts 1 and 2 above, please do the following:

  1. Print a copy of this form.
  2. Have the authorised person(s) sign Box A below. Please ensure you follow instructions for the Enrolment Process you have chosen.

Box A
Declaration and Assent to Incorporated Contracts

The undersigned company, acting by and through its authorised representative, hereby:

  1. Affirms that the information given in Item 1 above in this document is true and correct in all particulars;
  2. Enters into the BAL Service Contract, which is incorporated into this Box A by this reference, and which Agreement obligates the undersigned to comply with the Bolero Rulebook as therein incorporated;
  3. Confirms its earlier assent to the Operational Service Contract already in effect between the undersigned and Bolero International Limited;
  4. Agrees that all legal questions arising in relation to this Box A shall be determined in accordance with English law, and that the English courts have jurisdiction to determine such questions.
Company Name:
Signature:Signature:(if required):
Print name:Print name:
Title:Title:
Date:Date:

Please send these documents by mail (or courier service) to:

Bolero Association Limited
14th Floor, Centre Point Tower
103 New Oxford Street
London WC1A 1DD
United Kingdom

If you have any enrolment related questions please feel free to contact:

Bolero Association: +44 (0)20 7759 7000
admin@boleroassociation.org

Bolero support: +44 (0)20 7759 7030
support@bolero.net