2007 MEMBERSHIP APPLICATION
Brazil-Tampa Bay Chamber of Commerce
P O BOX 6338 - BRANDON, FL 33508 USA
Print and complete this form, and mail it to the above address, along with your check made payable to Brazil-Tampa Bay Chamber of Commerce, Inc. Annual dues for 2007 are:
Type of membership: President’s circle $1,650.00 (All employees may attend events at member rates)
SPONSOR
CORPORATE
GOLD CORPORATE
S.
CORPORATION INDIVIDUAL
$750 $450
$350
$250 $230
On new member applications there is a one-time processing fee of $25.00. Please add to your total payment
NAME 1: ____________________________________ TITLE: _______________________
NAME 2: ____________________________________ TITLE: _______________________
COMPANY: _______________________________________________________________
MAILING ADDRESS: _______________________________________________________
CITY, STATE, ZIP: __________________________________________________________
PHONE: ____________________________ FAX: _______________________
E-MAIL: ___________________________ Website: ______________________
DESCRIPTION OF COMPANY:
__________________________________________________________________________________________
__________________________________________________________________________________________
Regions in which your company is active (optional):
Argentina Brazil Bolivia
Chile Colombia
United States
Other: ________
Company classification (select one only, see below):
1. Accounting services
13. Manufacturers
2. Advertising/public relations 14. Real estate services
3. Associations
15. Retailers
4. Attorneys
16. Schools/education
5. Banks/financial institutions
17. Students
6. Communications providers
18. Telecommunications
7. Consultants
19. Translation services
8. Distributors
20. Transportation providers
9. Export/import trading & management
21. Utilities
10. Freight forwarders/customs brokers
22. No company affiliation
11. Government agencies/officials
23 Other: ___________________________
12. Insurance agents/providers
EMPRESAS BRASILEIRAS:
Filiação Anual Online - Online Payment
2CheckOut.com Inc. (Ohio, USA) is an authorized retailer for goods and
services provided by Brazil-Tampa Bay Chamber of Commerce.
Pay online your S. Corporate Membership
2CheckOut.com Inc. (Ohio, USA) is an authorized retailer for goods and
services provided by Brazil-Tampa Bay Chamber of Commerce.