Zambia Association of Chambers of Commerce & Industry : MEMBERSHIP FORM

* Fields that must be filled

Membership Application / Renewal Form

Section 1

Company Name:	*
VAT Registration Number:	*
Postal:	Contact Address *
Physical:	*
Job Title:	Contact Person *
Contact Phone:	*
Managing Director/General Manager:	*
Town/City:	*
Telephone Numbers:	*
Fax:	*
Email address:

Section 2

Your Type of Company:	Public Company Co-operative Partnership Private Company State Owned Other Type
Subsidiary of:
Year of Incorporation:	*
Certificate of Incorporation Number:	*
Local:	Ownership (in percentage)
Foreign:
Government:

Section 3

	Are you a member of any Chamber/Trade Association? Yes No
If YES, Chamber/Trade Association name:
	How would you classify you company? Large Medium Small
2001:	Total Company's Turnover for the following periods
2002:
2003:
2001:	Total Number of Employees for the following periods
2002:
2003:

Section 4

Type & range of products/services offered:
Products Exported:	Any principle exports involved in
	Do you wish to go into any kind of venture or be any Agent for any foreign company? Yes No
Is there any special service that you would like ZACCI to offer to your company? If so, state the nature of service required.
Indicate, in your own view, issues of economic importance which you feel ZACCI should be focusing on now or in the future.

Section 5

Quality of service:	What are your views about ZACCI in terms of...
Being pro-active on issues affecting business:
focusing on the needs of the general membership:
Any other comment:

Thank you for your support