Membership Application Form M403A

Online Membership Application Form M403A [U.S. Companies]

Company name*

Individual [Last, First, Middle Initial]*

Legal Form* Sole Proprietor Ltd./LLC   Corporation Non Profit Organization

Ticker Symbol / Nyse, Nasdq, S&P/

Fed. Tax ID*

DUN & Brad.

Headuarters address*

City*

State*

ZIP*

Subsidiary address

Phone* [including area code]

Fax

Website

E-Mail*

Contact person*

Position*

Industry sector*

Major product(s)/service(s)*

Number of Employees*    Full Time           Part Time

Small business member* Yes   No

Number of members/associations only/

Individual member Yes   No

Refering member

Note: *All areas indicated by an asterisk are mandatory!

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Send Application together with your check to:	Type of Membership	Annual Cost
	Corporate Council Membership (includes unlimited membership, seat on the Corporate Council Board)	$2500
	Corporate Membership	$1050
	Medium Size Companies	$850
	Small Companies	$650
	Individual Membership	$450
	Student Membership	$50
NORTH AMERICAN-BULGARIAN CHAMBER OF COMMERCE Attn: Membership Department 25143 Jack Rabbit Acres, Escondido, CA 92026 Email: usa@nabcc.org	Bank of America, Escondido Branch North American-Bulgarian Chamber of Commerce Account: в„–. 01692-09894 Routing в„–. 121000358 SWIFT: BOFAUS6S

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Company name*
Individual [Last, First, Middle Initial]*
Legal Form*	Sole Proprietor Ltd./LLC Corporation Non Profit Organization
Ticker Symbol / Nyse, Nasdq, S&P/
Fed. Tax ID*
DUN & Brad.
Headuarters address*
City*
State*
ZIP*
Subsidiary address
Phone* [including area code]
Fax
Website
E-Mail*
Contact person*
Position*
Industry sector*
Major product(s)/service(s)*
Number of Employees*	Full Time Part Time
Small business member*	Yes No
Number of members/associations only/
Individual member	Yes No
Refering member
Note: *All areas indicated by an asterisk are mandatory!