Membership Application ⇽ Sponsor | Italian Chamber of Commerce and Industry in Australia Inc. on Glue Up

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・one upper case letter
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First Name *

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Last Name *

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Email *

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Company *

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COMPANY WEBSITE

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Country/Region

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Mobile number *

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Assistant Name

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Assistant Email

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Assistant's mobile phone

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Address *

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City *

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State/Province *

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Please Select Valid Province Value

State/Province *

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State/Province *

Please fill in the below form with your company details.

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Company Logo

Please select your Membership option and upload your company logo if you are applying for any of the following:

Sponsorship
Corporate Membership
Business Membership
Overseas Membership

Membership Type *SponsorCorporate ($6,000)Enterprise (21+ employees) ($1,300)Small Business (1-20 employees) ($750)Individual ($450)Overseas (€ 500)

Please select no more than 1 option

Contact Details

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Company Name *

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Address *

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City *

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Postal Code/Zip Code *

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State/Province *

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Please Select Valid Province Value

State/Province *

Please Select Valid Province Value

State/Province *

Please select an option

Country/Region *

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Primary Contact Person *

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Email *

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Phone

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Administration Email

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Please enter a value for the other option. The value cannot exceed 255 characters.

Sector

Industry

Facts & Figures

Number of Employees *:

Test Group

Select one or more options

Year of Establishment

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Annual Turnover

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States/Countries where your business operates

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Exclusive agent for (if applicable)

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Type of Activity

Company Description (up to 40 words)

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Membership Refund Policy

Glue Up account creation information.

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