Name of Company

Name & Surname of Representative

Company Registration Number

Year of Company Incorporation

Brief description of company activity

Number of employees

Yearly average business volume (for the past 3 years)

Address & Area Code

PO Box & Area Code

Telephone Number

Mobile Number

Email Address (of the representative)

Company Website

If your company is a subsidiary or branch of a U.S. firm please supply the full name and address of your mother company.

If your company represents U.S. companies in Cyprus, please list the specific products you represent from each U.S. company.

Select Membership Type : See above table for eligibility requirements Select Membership Type : See above table for eligibility requirements €1000 - Corporate/Sustaining €400 - Business €150 - Individual

Personal & Company Data Personal & Company Data I hereby authorise the CCCI and AmCham Cyprus to use my personal data, as well as our company data for the purposes of the aforementioned Business Association but also for informing us about other activities organized by the CCCI, AmCham and/or the Business Associations operating under its auspices. I also consent to the uploading of my personal and our company data, as well as photographs on websites and/or social media.

Terms & Conditions Terms & Conditions I hereby declare our interest for membership to the Association. I understand that our eventual application shall be considered provided that we fulfil all commitments, in accordance to the Memorandum & Articles of Association.