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THE JERSEY CHAMBER OF COMMERCE

APPLICATION FORM FOR MEMBERSHIP 2011/12
 
A) COMPANY DETAILS
Company Name *
Building / House Name *
PO Box  
Road / Street *
Parish *
Country *
Post Code *
Telephone Number *
Fax Number  
Office Email Address *
Website Address  
 
B) PRIMARY REPRESENTATIVE DETAILS
Position *
Title *
Christian Name / s *
Surname *
Direct Telephone Number *
Direct Email Address *
Mobile Telephone Number *
 
C) ADDITIONAL REPRESENTATIVE DETAILS
Up to five additional representatives free of charge. This option ensures any additional representatives receive all Chamber correspondence direct via email. (Please ensure they consent to the use of their details in accordance with paragraph f below)
1) First Additional Representative Name  
Position  
Direct Telephone Number  
Direct Email Address  
 
2) Second Additional Representative Name  
Position  
Direct Telephone Number  
Direct Email Address  
 
3) Third Additional Representative Name  
Position  
Direct Telephone Number  
Direct Email Address  
 
4) Fourth Additional Representative Name  
Position  
Direct Telephone Number  
Direct Email Address  
 
5) Fifth Additional Representative Name  
Position  
Direct Telephone Number  
Direct Email Address  
 
D) BUSINESS DESCRIPTION, a description of your principle business activities (max 200 characters)
 
E) PROPOSER, please give details of a current Chamber Member who has accepted to propose you as a member. If you do not have a proposer please leave blank
 
F) USING YOUR INFORMATION
By being a member of Chamber you are consenting to have the name of your business published in any current membership list and to the use of your information by Chamber as noted below. In addition Chamber is committed to promoting its members’ interests to other parties for the purpose of promoting trade in the island.
 
Please check the box if you consent to have your company contact details (Section A) and the name and position of your primary representative (but not their direct contact details) passed onto selected third parties (some of whom may be based outside the EEA) for a variety of purposes, which may include direct marketing of goods and services which may be of interest to you.
 
Please check the box if you consent to have your company contact details (Section A) and the name and position of your primary representative (but not their direct contact details) published in any Chamber publications (including the website and online business directory).
 
Please note that any direct contact details included in sections B and C will only be used by Chamber in order to inform members of Chamber events and to communicate matters judged to be of relevance by Chamber (which may include direct marketing of goods and services), and for the purposes of issuing surveys. By being a member of Chamber you are consenting to such use. Chamber will rely on you to notify it of any changes to your information.
 
G) CATEGORY
Please state the total number of employees in your business
 
Submit form:
By submitting the form online you are agreeing to be bound by the above. Print name:		 *
Date: *
 
As part of our continued membership drive, we are pleased to announce a special offer for any business joining Chamber before the end of February 2012; they will receive membership to the end of May 2013 (Annual Subscription year runs May to May).
Category Tick   £
A Employing up to 5 persons 102.00
B Employing 6 to 20 persons 131.00
C Employing 21 to 30 persons 183.00
D Employing 31 to 50 persons 283.00
E Employing 51 to 100 persons 351.00
F Employing 101 to 200 persons 439.00
G Employing 201 to 400 persons 742.00
H Employing 401 to 700 persons 1,007.00
I Employing 701 persons upwards 1,069.00
J Individual Private Members (Retired Members Only) 19.00
 
 
Payment method:
Cheque
Please make cheques payable to: The Jersey Chamber of Commerce
BACS
Payment direct to Chamber's account:
Account Number: 06323022
Sort Code: 60-12-03
Account Name: Jersey Chamber of Commerce
Bank: NatWest, Library Place, Jersey
Please ensure all remittance payments are returned with a company name as reference.
Direct Debit
Please contact the Chamber offices for a direct debit mandate.
 
 

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