Membership Application

SACCI Online Membership Application

COMPANY NAME *

PHYSICAL ADDRESS *

POSTAL ADDRESS *

CITY *

POSTAL CODE *

TELEPHONE No *

FAX NO *

TYPE OF MEMBERSHIP * Chamber
Corporate Entity
Association

WEBSITE

ACTIVITIES OF THE COMPANY *

VAT NUMBER

NAME OF CHAIRMAN

NAME OF MANAGING DIRECTOR / CEO

NAME OF FINANCIAL DIRECTOR

NAME OF SENIOR ASSOCIATE

E-MAIL ADDRESS

ORDER NUMBER (if applicable)

NAME OF PERSON RESPONSIBLE FOR AUTHORISING MEMBERSHIP

DESIGNATION

DATE OF APPLICATION *