MEMBERSHIP APPLICATION FORM

Become a Member

I/We desire to be admitted to the membership of the Congolaise Chamber of Commerce International and Industry upon the terms of and subject to all the rules of the Congolaise Chamber.

1 Company Details

Company Name *

Year of Establishment

Sector

Physical Address

Telephone Number

E-mail Address

PIN / VAT

Date of Application

2 Contact Information

Contact Person 1

Name

Designation

E-mail Address

Telephone Number

Contact Person 2 (optional)

Name

Designation

E-mail Address

Telephone Number

3 Product / Service Description

Products Manufactured

Services Offered

Products Imported

Products Exported

Retailer / Distributor of

Number of Employees

Annual Turnover (KES / USD)

Number & Countries in Operation

4 Membership Category

Select your annual subscription category

5 Mode of Payment

ECO BANK — Bank deposit / EFT / RTGS

KES A/C No. 6580022494
USD A/C No. 658002249

Cheque

Payable to: The Congolese Chamber of Commerce, International and Industry

Payment Method

Cheque No. (if applicable)

Amount (Ksh / USD)

6 Supporting Documents

Business Registration / Certificate of Incorporation PDF, JPG or PNG. Max 5 MB.

PIN / VAT Certificate PDF, JPG or PNG. Max 5 MB.

Note: Please attach a copy of the Business Registration Certificate / Certificate of Incorporation and the PIN/VAT Certificate. Membership contributions are nonrefundable.