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APPLICATION FOR ASSOCIATE MEMBERSHIP OF
MAURITIAN CHAMBER OF COMMERCE AND INDUSTRY (AUSTRALIA)

Name

Surname

Address

Occupation

Employer

Work Tel:

Home Tel:

Fax:

Email:

Qualifications/Trade/Business:

Homepage Address:

 

 

 

 

In the event of my admission as an Associate Member, I agree to be bound by the Rules of the Association for the time being in force.

 

Signature: …………………………..

Dated: …………………………..

Describe fields in which I can offer assistance to other members:

Special Expertise (Please describe):

Name of Proposer (Founder Member):

Name of Seconder (Founder member):

Signature:

Signature

Dated:

Dated

Please return completed form with $25. remittance to
Clancy J Philippe,
Secretary, MCCI (Aust.),
PO Box 7640, Dandenong,
Vic 3175, Australia
(You may contact the Secretary (Clancy J Philippe) on tel: 03 9782 4990 for further details)