* The following information is required

*Company Name:
*Company URL:
*Product Name with Version:
Are you a member of Liberty Alliance? Yes / No NOTE: Testing is open to non-members of Liberty Alliance but additional test fees are required as well as signing the Liberty AllianceTMLA.

*Check all conformance modes which are relevant for your product

IdP
IdP Lite
SP
SP Lite
Attribute Authority Responder
Attribute Authority Requester
Authorization Decision Authority Requester
Authorization Decision Authority Responder
Authentication Authority Requester
Authentication Authority Responder
POST Binding

(Certification in IdP Extended or SP Extended is conditional on completing IdP or SP respectively. You must also register for IdP or SP as a prerequisite.)
IdP Extended (Requires IdP)
SP Extended (Requires SP)

(Certification for eGov profile is conditional on completing at least one of the following modes: SP, SP Lite, IdP or IdP Lite. You must also register for one of those modes as a prerequisite.)
eGov Profile (Requires either SP, SP Lite, IdP or IdP Lite )

Administrative Contact

This person is the primary point of contact and is responsible for the overall relationship and commitment of resources.

*First Name:
*Last Name:
*Title:
*Address:
*Phone:
*Fax:
*eMail:

Accounts Payable Contact

If specified invoices will be directed here, otherwise they will be sent to the administrative contact.

Check here if the Accounts Payable contact is the same as the Administrative Contact

Name and Title:
Address:
Phone:
Fax:
eMail:

Technical Contact

This person is required to operate and support your product during the execution of the interoperability test.

Check here if the Technical contact is the same as the Administrative Contact

Technical Contact 1
Name and Title:
Phone:
eMail:
Technical Contact 2
Name and Title:
Phone:
eMail:
Technical Contact 3
Name and Title:
Phone:
eMail:
Technical Contact 4 d
Name and Title:
Phone:
eMail:

Press Contact

If specified all press releases and other advertising or marketing collateral will be cleared with this person prior to their release, otherwise the administrative contact will be used.

Check here if the Press contact is the same as the Administrative Contact

Name and Title:
Address:
Phone:
Fax:
eMail: