Membership — African Irish Chamber of Commerce

Membership Application Form

Personal Information Full Name: Date of Birth: Gender: Nationality: Street: City: Postal Code: Country: Phone Number: Email Address:

Professional Information Company Name: Position/Title: Industry: Company Street: Company City: Company Postal Code: Company Country: Company Phone Number: Company Email Address:

Membership Details Type of Membership: How did you hear about us?

Business Interests Please select areas of interest:
Networking
Business Development
Trade Missions
Investment Opportunities
Events and Seminars
Advocacy
Market Research
Other (please specify)

Additional Information Briefly describe your business and how you intend to engage with the Chamber:

Payment Information Membership Fee: Payment Method:

Declaration

I hereby apply for membership of the African Irish Chamber of Commerce. I agree to abide by the Chamber's constitution and rules.

Signature: Date:

Upon submission of this form, a member of the AICC will contact you for payment and next steps.