Application Form

Application For Membership

Argentia Area Chamber of Commerce

McCormack Bldg.
1 O'Reilly Street
Placentia, NL A0B 2Y0
Fax (709)227-0016

Print, fill out, and fax the following form to the number listed above.

I, ____________________ of ____________________ being desirous of
(Name) (Town)
becoming a member of the
ARGENTIA AREA CHAMBER OF COMMERCE, hereby apply to be as a member thereof subject to the provisions of the Memorandum and Articles of the Chamber.

Dated at ___________________________ this _______________ day of ______________ ,
20________.

Signature ___________________________

COMPANY INFORMATION

Company Name __________________________

Company Contact _________________________

Position _________________________
Address _________________________

Postal Code ___ ___ ___ ___ ___ ___

Telephone Number __ __ __ __ __ __ __ __ __ __

Fax Number __ __ __ __ __ __ __ __ __ __

E-Mail _________________________

Type of Business _________________________

Description of products and/or service _____________________________________

Company Name	__________________________
Company Contact	_________________________
Position	_________________________
Address	_________________________
Postal Code	___ ___ ___ ___ ___ ___
Telephone Number	__ __ __ __ __ __ __ __ __ __
Fax Number	__ __ __ __ __ __ __ __ __ __
E-Mail	_________________________
Type of Business	_________________________
Description of products and/or service	_____________________________________