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Members Directory
» 2007 APPPLICATION

Company/Organization
Contact Person
Address
City State Zip
Business Telephone Fax
e-mail Address
Nature of Business
Do you Import/Export? To What Counties?
Company President/CEO
Primary Representative
Name (Signature) Title

MEMBERSHIP DUES
Personal    
Business Class 1    
Business Class 2    
Business Class 3    
Non-Profit Organizations    
Financial Institutions, Hospitals    
Corporative    
Gold Sponsor    
Platinum Sponsor    
Contribution to Scholarship Fund   $100.00
Contribution to Scholarship Fund   Other Amount
       
    TOTAL AMOUNT $
       
Mail your payment to:
Gulf Coast Latin Chamber of Commerce
Membership Dues
8051 North Tamiaimi Trail, C-2, Box 37
Sarasota, FL 34243

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® 2007 Gulf Coast Latin Chamber of Commerce ·Manatee / Sarasota, Florida