:: Member Application Form

Please complete the form below to join the Carmarthenshire Chamber. Payments can be made via cheque / Invoice or Direct Debit, on completion of form, please continue to the next page to select your payment option.

Company Name:	*
Contact Name:	*
Address:	*
Post Code:	*
Telephone:	*
Email:	*
Website:	[?]
Industry Sector:
Main Activity:
The information provided within this section will be used to compile an online business directory to help promote your business.
Number of employees:	*
Reason for joining:	*
How did you hear about the Carmarthenshire Chamber?	*
Are you interested in being part of your local chamber network?	Yes No
If yes, please indicate preferred local chamber:
Position in company:	*
Date:	* [DD-MM-YYYY]

Membership of The Carmarthenshire Chamber 2006/2007 Remittance advice

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Field marks with (*) is Compulsory

Number of Employees	Fee (£)	Please Tick
Sole Trader	30
1-5	40
6-10	75
11-20	130
21-50	280
51+	675
Retired members	30
Charities	30