USMCOCCA - United States-Mexico Chamber of Commerce California Regional Chapter

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	Membership Benefits

	Membership Categories

	Bi-National Membership

	Regional Membership

	Corporate Membership

	Individual Membership

	Associate Membership

	Application Form

Company Representative to Chamber:

Title:

Division:

Company:

Address:

City:

State:

Zip Code:

Telephone:

Extension:

Fax:

Telephone2:

E-mail:

Website:

Type of Business:

Date Founded:

Sales Volume:

Employees:

Do you have an office in Mexico?

Yes

If yes, where in Mexico?

Application is hereby made for membership in the United States-Mexico Chamber of Commerce.

Remittance of $

is enclosed for the following type of membership:

		Bi-National $7,500 8 Representatives
		Regional $2,500 5 Representatives
		Corporate $1,800 4 Representatives
		Corporate $1,500 3 Representatives
		Corporate $1,000 2 Representatives
		Corporate $500 1 Representative
		Individual $300 1 Representative
		Associate $100 1 Representative
		Student $25

Please enclose the contact information of the company designated executives that will receive the USMCOC-NE benefits.
Please enclose a paragraph with your corporate profile, including a company history description, your mission, a description of your products/services, and/or any promotional materials from your company.

Payment by credit card: Please charge my credit card:

MasterCard

Visa

The amount of $

Name on credit card:

Credit Card Number:

Exp. Date:

Payment by check: Make checks payable to: 2450 Colorado Ave., Suite 400 E, Santa Monica, CA 90404

Note: This form is submitted via email to the USMCOC-CA and as such is not secure. You may opt to call us with your credit card information to (310) 586-7901 or fax this form to (310) 586-7800.