Membership Application Form (MCM) – The Canadian Chamber of Commerce of the Philippines

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THE CANADIAN CHAMBER OF COMMERCE OF THE PHILIPPINES

CORPORATE

MEMBERSHIP CATEGORY*

PAYMENT TERMS:*

PRINCIPAL ADDRESS*

APPLICANT'S NAME: *

Address*

Street Address City State / Province / Region Postal / Zip Code Country

TELEPHONE:*

FAX:*

EMAIL ADDRESS:*

Copy of SEC/DTI registration (PDF)*

TAX IDENTIFICATION NUMBER (TIN):*

WEBSITE:*

COMPANY PROFILE:*

REGULAR REPRESENTATIVE:*

Title

First

Last

Middle

POSITION:*

NATIONALITY: (Regular)*

TELEPHONE: (Regular)*

MOBILE: (Regular)

EMAIL: (Regular)*

ALTERNATE REPRESENTATIVE:*

Title

First

Last

Middle

POSITION: (Alternate)*

NATIONALITY: (Alternate)*

TELEPHONE: (Alternate)*

MOBILE: (Alternate)

EMAIL: (Alternate)*

COMPANY LOGO*

REPRESENTATIVES' PHOTO

SIGNED INTEGRITY PLEDGE*

The information provided in this application may be used by ��APP�� for input in all or any of ��APP��'s searchable databases, membership directories or events' notices and, as such, may therefore become available to the public within or outside of the Philippines. I hereby agree to the release of the data and/or personal information by ��APP�� for the intended use by ��APP��. Please mark your choice: *

YES

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