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| B-2-3-1, Solaris Dutamas, Jalan Dutamas 1, | |||||||||||
| 50480 Kuala Lumpur, Malaysia | |||||||||||
| email : msia_europe.chamber@yahoo.com | |||||||||||
| Membership Application Form | |||||||||||
| My Company would like to join as an ordinary member of MALAYSIA AND CENTRAL EASTERN EUROPE CHAMBER OF COMMERCE | |||||||||||
| My company agrees to pay a monthly membership fee of RM5.00 per month or RM60.00 per annum, whichever convenience. | |||||||||||
| Company Name | : | ||||||||||
| Company Business and Profiles | : | |
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| Company Address | : | ||||||||||
| Contact Person and Number | : | (1) | Name | : | |||||||
| Designation | : | ||||||||||
| Email address | : | ||||||||||
| Contact (O) | : | ||||||||||
| Contact (M) | : | ||||||||||
| (2) | Name | : | |||||||||
| Designation | : | ||||||||||
| Email address | : | ||||||||||
| Contact (O) | : | ||||||||||
| Contact (M) | : | ||||||||||
| Company stamp and signed | |||||||||||

MALAYSIA AND CENTRAL EASTERN EUROPE CHAMBER OF COMMERCE ____________________________________________________________________