Membership Application

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Phone: 242.367.5822

Registered Association

Name of Firm, Association, Corporation or Individual

Type of Business:

Construction

Professional Business Services

Transportation

Manufacturing

Tourism

Sales

Agriculture/Fisheries

Address

Postal Address

Phone

Web Address

Fax

Email

Designated Representative

Class of Membership and Fees ($100/Annum)

Individuals, Self-Employed (Class A)

Small Business (Class B) 2-10 Employees

Medium Business (Class C) 11-30 Employees

Large Business (Class D) 31-80 Employees

X-Large Business (Class E) 81+ Employees

Your Signature

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