(** Required Field)
Member Types
Regular $1,650
Associate $950
Individual $950
**
Your Name:
**
Your Title:
**
Your E-mail:
Company Information
**
Company Name:
**
Address1:
Address 2:
**
Address 3:
City:
State:
Zip:
**
Company Phone:
**
Company Fax:
Company E-Mail:
Company Homepage:
Chief Representative Information
**
Chief Rep. Name:
First:
Middle:
Last:
**
Chief Rep. Title:
**
Chief Rep. Phone:
Chief Rep. Fax:
**
Chief Rep. E-mail:
Secretary Name:
Secretary Phone:
Secretary Fax:
Secretary E-mail:
Contact Person Information
**
Contact Name:
First:
Middle:
Last:
**
Contact Title:
**
Contact Phone:
Contact Fax:
**
Contact E-mail:
Additional Information
**
Company Profile:
# Of Employees:
Comments:
We don't accept credit cards. Please remit membership dues to JCCI. We are sorry about this inconvenience.
(c)2006 All rights reserved. Japanese Chamber of Commerce and Industry of New York, Inc.
