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Danish Canadian Chamber of Commerce - Membership Application Form

Member
Surname  
 _________________________________________
First Name  
 _________________________________________
Title  
 _________________________________________
Home Tel.  
 ____________________________________
Direct Email  
 _________________________________________
Additional Member (corporate only)
Surname  
 _________________________________________
First Name  
 _________________________________________
Title  
 _________________________________________
Home Tel.  
 ____________________________________
Direct Email  
 _________________________________________
Company Information
Company  
 _________________________________________
Address  
 _________________________________________
_________________________________________
City  
 _________________________________________
Province  
 _________________________________________
Postal Code  
 _________________________________________
Country  
 _________________________________________
Telephone  
 ____________________  Ext ___________
Fax  
 _________________________________________
Mobile  
 _________________________________________
Email  
 _________________________________________
Corporate Website  
 _____________________________________________
Brief Description  
of Your Business  
 _________________________________________
_________________________________________
_________________________________________
Membership Fees

Membership Type  
(check one only)   

    Sponsor Member
   Corporate Member
   Individual Member
Membership fees:  
   Sponsor $750    Corporate $400     Individual $95
   
  Payment may be made by sending a cheque to:
   

Danish Canadian Chamber of Commerce
2 Bloor Street West, Suite 2120
Toronto, Ontario
Canada   M4W 3E2

Tel: 416.923.1811   Fax: 416.962.3668   Email: info@dccc.ca

   
 Check if you wish to have membership information sent to you.