test - Dural & District Business Chamber

Dural and Round Corner Chamber
of Commerce and Industry Inc.
ABN 72 062 209 606
PO Box 2, Round Corner NSW 2158
Email: [email protected]
Phone: 0497 014 950
www.duralchamber.com.au

Business Information

Business/ Trading Name *

ABN *

Business Address *

Postal Address *

Business Website

Social Media Links

Describe your Business / Services / Products

Member Information

Primary Member’s Name

Position

Primary Email *

Phone

Additional members who are able to attend forums, meetings and social gatherings (without voting rights at the AGM)

Additional Member’s Name

Position

Additional Member’s Name

Position

I (Full Name) *

Position

Of (Business Name)

check principal *

hereby apply for Membership of the Dural and Round Corner Chamber of Commerce & Industry Inc on behalf of the above named business. In the event of my admission as a member, I agree to be bound by the rules of the Chamber. I confirm that I wish my business details to be provided to the NSW Business Chamber as part of the Alliance Program. If I wish to opt out of the NSW Business Chamber Alliance Program, I will tick this box

Signature ( Draw Your Signature ) *

Date / Time

Membership Fee price *

Price: $150.00

Do you want to make a recurring membership payment? *

Debit or Credit Card *

Card

Name on Card

Security Question *

Dural And District Business Chamber

Dural And District Business Chamber

Business Information

Member Information

Additional members who are able to attend forums, meetings and social gatherings (without voting rights at the AGM)

Our Members