Please Complete and Post/Fax Back to the Details Below

MEMBERSHIP APPLICATION

Please complete and post/fax back to the details below

Contact Name:

Position:

Company Name:

Address:

Postcode:

Telephone Number:Email:

Mobile Number:Website:

Fax Number:

Number of Employees:

Description of Business (for inclusion in directory):

Do you? (please tick) IMPORT EXPORT

I/We wish to apply for Membership of the West Kent Chamber of Commerce & Industry and undertake to be bound by the Memorandum and Articles of Association (copies available on request).

Authorised Signature

Name:Date:

Introduced by:

The WKCCI will use any information provided on this form (including personal data as defined by the Data Protection Act 1998) for processing your membership and for its general marketing purposes. It may also disclose such information to its members for their general marketing purposes. Please tick this box if you do not wish the information on this form to be used in this way

Please note following election as a member no part of the annual membership fee is refundable. PAYMENT METHOD

ChequeVisa Mastercard SwitchSecurity No:

Card Number

Expiry Date:Start Date: Switch Only – Issue Number:

Amount £Signature:

BACS Ref: Company Name Sort Code 20 88 13 Account 30096180

SUBSCRIPTION RATES - Administration fee on joining £30 + VAT

No. of Employees / Subscription / VAT /

Total

Sole Trader / £235.00 / £ 47.00 / £282.00
2 - 9 / £270.00 / £ 54.00 / £324.00
10 - 19 / £310.00 / £ 62.00 / £372.00
20 - 49 / £360.00 / £ 72.00 / £432.00
50 - 99 / £465.00 / £ 93.00 / £558.00
100 - 199 / £565.00 / £113.00 / £678.00
200+ / £665.00 / £133.00 / £798.00

Export Membership £410.00 £ 82.00 £492.00

West Kent Chamber of Commerce and Industry Telephone: 01892 774769

17 Church Road Fax: 01892 800153

Tunbridge Wells Website:

Kent TN1 1LG Email: