PARTNERSHIP APPLICATION FORM

Become a Partner

We desire to enter into partnership with the Congolaise Chamber of Commerce International and Industry under the partnership category indicated below, upon the terms of and subject to all the rules of the Congolaise Chamber.

1 Organisation Details

Organisation Name *

Year of Establishment

Sector / Industry

Physical Address

Telephone Number

E-mail Address

PIN / VAT

Date of Application

2 Contact Information

Contact Person 1

Name

Designation

E-mail Address

Telephone Number

Contact Person 2 (optional)

Name

Designation

E-mail Address

Telephone Number

3 Partnership Category

Select your annual contribution category

4 Mode of Payment

ECO BANK — Bank deposit / EFT / RTGS

KES A/C No. 6580022494
USD A/C No. 658002249

Cheque

Payable to: The Congolese Chamber of Commerce, International and Industry

Payment Method

Cheque No. (if applicable)

Amount (Ksh / USD)

5 Supporting Documents

Business Registration / Certificate of Incorporation PDF, JPG or PNG. Max 5 MB.

PIN / VAT Certificate PDF, JPG or PNG. Max 5 MB.

Note: Please attach a copy of the Business Registration Certificate / Certificate of Incorporation and the PIN/VAT Certificate. Partnership contributions are nonrefundable.