Specifications

13.56 MHz How to Order Guide – D00529, D.5

iCLASS Elite Program™ Request & Authorization Form

The iCLASS Elite program includes a credential format and custom authentication key. Use any format, including the HID

Corporate 1000 format. Corporate 1000 is a 35-bit card format available for qualified end-users by formal enrollment and

acceptance by HID Global. A custom authentication key provides increase security. HID assigns the key to guarantee

uniqueness, and programs the site-specific readers and credentials.

With the iCLASS Elite program, the end-user has the flexibility to choose any access control hardware/software platform, or any

HID System Provider. As the iCLASS Elite program end-user, enter your company information in TABLE I. Ensure all fields are

complete for the primary and secondary (if desired) authorized contacts within your company.

TABLE I: Your Company’s Primary and Secondary Contacts

Information Primary Company Contact Secondary Company Contact

Company Name

Mailing Address

City

State/Province

Country

Zip/Postal Code

Contact Name

Title

Contact Signature X X

Phone Number

Fax Number

E-mail Address

Enter the program features:

35-Bit Credential Format (if different, enter: )

Custom Authentication Key

Once accepted into the iCLASS Elite Program, HID shall grant a royalty free license to use the iCLASS Elite Program

within your organization. Sign below to enroll in this program and your acceptance of the License Agreement.

ACCEPTANCE OF HID CREDENTIAL PROGRAM LICENSE AGREEMENT

The undersigned party hereby accepts and agrees to be bound by the terms and conditions of the HID Credential Program.

License Agreement is located at www.hidglobal.com/pdfs/credential_license.pdf

, pursuant to which a license is granted to the

undersigned party authorizing the use of certain credential formats in connection with participation by the undersigned in the

HID iCLASS Elite Program.

Dated:

Authorized Signature : X

Company Name : Contact Name:

Title :