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CACCI Form # 1
(Application for Primary Membership)

The Director-General
Confederation of Asis-Pacific Chambers of Commerce and Industry
13F,3 Sungshou Road, Taipei, Taiwan 110
Tel : (886 2)2725-5663/4 ; Fax : (886 2)2725-5665 ; Email : cacci@ttn.net

We wish to apply as a Primary Member of the Confederation of Asia-Pacific Chambers of Commerec and Industry (CACCI). We agree to abide by our obligations and Responsibilities as a member. Pertinent information about our Chamber follows :

Username :

Password :

Name of Chamber :

Address :

Telephone :

Fax No.:

Email :

Website(URL) :

Officers : (Use another sheet if necessary.)

Name :

Position :

(Please furnish photo by express airmail or courier and biodata of Officers.)

Data Registered or Established :

No. of Members :

Publication(s):

(Please attach copies together with your organization brochure and latest Annual Reports.)

Data :

Signature :

Position :