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Apply for Membership Membership Level: Corporate Membership - $9500 Entrepreneur Membership - $5000 Individual Member - $1800 Young Professional Membership $1000 (Available to those under 35 Years of Age) 2 Year Membership Affiliate Membership Company Information Company Name: Company Website: Address Line 1: Address Line 2: City: Country: United States of America Canada Afghanistan Åland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia (Plurinational State of) Bonaire, Sint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cabo Verde Cambodia Cameroon Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo (the Democratic Republic of the) Cook Islands Costa Rica Côte d'Ivoire Croatia Cuba Curaçao Cyprus Czechia Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands [Malvinas] Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See Honduras Hong Kong Hungary Iceland India Indonesia Iran (Islamic Republic of) Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea (the Democratic People's Republic of) Korea (the Republic of) Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia (the former Yugoslav Republic of) Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia (Federated States of) Moldova (the Republic of) Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestine, State of Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Réunion Romania Russian Federation Rwanda Saint Barthélemy Saint Helena, Ascension and Tristan da Cunha Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (Dutch part) Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syrian Arab Republic Taiwan (Province of China) Tajikistan Tanzania, United Republic of Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom of Great Britain and Northern Ireland United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela (Bolivarian Republic of) Viet Nam Virgin Islands (British) Virgin Islands (U.S.) Wallis and Futuna Western Sahara* Yemen Zambia Zimbabwe Company Membership Directory Information Company Profile: Public Email (email to appear in the Membership Directory): Public Phone (Phone # to appear in the Membership Directory): Primary Contact's Information (Primary Representative) If you have registered for a Corporate Membership, you are entitled to a Primary Representative and 2 Sub-Members (Sub-Member 1 and Sub-Member 2). You will be given the option to fill in the details of your 2 Sub-Members on the final page of the registration process. Personal Information First Name: Last Name: Job Title: Contact Information Email: Work Phone: Mobile Phone: Additional Information University (if you attended a university outside of Canada please select "Others" and indicate below): Acadia University Algoma University College Athabasca University Augustana University College BCIT (British Columbia Institute of Technology) Bishop's University Brandon University British Columbia Open University Brock University Canadian University Association Carleton University Concordia University College of Alberta Dalhousie University École Polytechnique de Montréal First Nations University of Canada HEC Montréal Lakehead University Laurentian University Malaspina University College McGill University McMaster University Memorial University of Newfoundland Mount Allison University Mount Saint Vincent University Nipissing University Okanagan University College Queen's University Redeemer University College Richard Ivey Royal Roads University Ryerson University Saint Mary's University Saint Paul University Simon Fraser University St. Francis Xavier University St. Thomas University The King's University College Trent University Trinity Western University Université de Moncton Université de Montréal Université du Québec à Montréal (UQAM) Université du Québec Université de Saint-Boniface Université de Sherbrooke Université Laval Université Sainte-Anne University College of the Cariboo University College of the Fraser Valley University of Alberta University of British Columbia University of Calgary University of Guelph University of King's College University of Lethbridge University of Manitoba University of New Brunswick University of Northern British Columbia University of Ottawa University of Prince Edward Island University of Regina University of Saskatchewan University of Sudbury University of Toronto (UofT) University of Victoria University of Waterloo University of Western Ontario University of Windsor University of Winnipeg Western University Wilfrid Laurier University York University Others University (Outside of Canada): If you would like us to cc your personal assistant in correspondence please let us know below: Contact Personal Assistant (PA)? Yes No PA Name: PA Email: PA Phone: What Is Your Preferred Payment Method? Preferred Payment Method HSBC PayMe FPS Bank Transfer Cheque Credit Card How to Pay (1) Payment by HSBC PayMe Please scan the QR code below and include a note with your company or full name: (2) Payment by FPS FPS Identifier: 169600574 Please include a note with your company or full name (3) Payment by Bank Transfer Account number: 043-239359-001 Beneficiary name: The Canadian Chamber of Commerce in Hong Kong Bank name: The Hong Kong and Shanghai Banking Corporation Limited (HSBC) Bank address: G/F, 23 Lyndhurst Terrace, Central, Hong Kong SWIFT code: HSBC HK HHH KH Please include a note with your company or full name (4) Payment by Cheque Deposit the cheque directly to The Hong Kong and Shanghai Banking Corporation Limited (HSBC) Beneficiary name: The Canadian Chamber of Commerce in Hong Kong Account number: 043-239359-001 Please include a note with your company or full name during deposit And email canada@cancham.org a deposit receipt or photo/scan of your cheque (front and back) (5) Payment by Credit Card To pay by CREDIT CARD please select "PAYPAL" on the final page. PayPal login is NOT required. Please calculate and add the 5% service charge before submitting credit card payments on PayPal *Terms and Conditions 1. No Refund. You may choose to cancel your membership at any time but you won't be issued a refund. 2. Please include a note with your company and Full Name Neon CRM by Neon One
