Make checks payable to : British American Chamber of Commerce Broward County
Mailing Address : BACC SF, c/o: Roy Yates, 2800 N.E 41st Street,Lighthouse Point,Florida 33064 USA
FAX : 954 942 3588
Application Type: [ ] New Membership [ ] Renewal
Company Name: ______________________________________________________________
City: _________________________________ State: _______ Zip Code: _____________
Contact Name: __________________________________ Title: ______________________
Telephone: ______________________________ Ext.: ______ Fax: __________________
Web Site: ___________________________________________________________________
Would you like this web site displayed as part of your profile on the BACC Broward County web site?
[ ] Yes, display this web site address. [ ] No, do not display this web site address.
E-mail: (this e-mail address will not be displayed on the web site)
Brief Business Description: ______________________________________________________
If you were referred by an existing BACC Broward County member, please tell us!
Member Company: ______________________________________________________________
Contact Name: _________________________________________________________________
Web site contact preference: (select one)
As a BACC Broward County member you are entitled to one free "baccbroward.org" e-mail address.
You can select to use the BACC e-mail address, a personal or business e-mail address, a contact telephone number, or none for contact through the BACC Broward County web site. This is the contact information that will be displayed to viewers of the BACC Broward County web site, including potential business contacts.
[ ] baccsouthflorida.org e-mail address
[ ] My own e-mail address (please specify): __________________________________________
[ ] Telephone number (please specify): ______________________________________________
[ ] Do not post any contact information on the BACC Broward County web site
Membership Type: (select one)
[ ] Trustee ($1,050.00 US per year) [ ] Individual ($150.00 US per year)
[ ] Corporate ($350.00 US per year) [ ] Foreign Business ($150.00 US per year)
[ ] Small Business ($250.00 US per year) [ ] Student ($25.00 US per year)
Category: (select the one that best describes you or your company)
[ ] Professional Services (i.e. Medical, Law, Accounting, etc.)
[ ] Real Estate / Property Management
[ ] Travel (i.e. Airline, Cruise Line, Ground Transportation, Agency, etc.)
[ ] Technology & Telecommunications
[ ] Printing / Graphics / Publishing
[ ] Insurance / Risk Management / Security
[ ] Banking / Financial / Investment
[ ] Consumer Sales (i.e. Automotive Dealer, Retailer, etc.)
[ ] Shipping / Distribution / Logistics / Freight Forwarding
[ ] Manufacturing / Assembly / Distribution
[ ] Individual (use only if membership type is Individual or Student)
[ ] Miscellaneous / Other: _________________________________