Membership Application Form

Designated Representative:			
Company/Organization:		
Position Held:			
Address:		
Telephone:  		Fax:		
e-Mail:		Website:		

Description:
Industry:		Market Areas:		
Products/Services Offered:		

Business Interest (Please check):	
Investment			Joint Venture		
Technology Cooperation		Trading		
Merger/Acquisition		Business Development		
Other (specify):		

Comments:  How may CCSSTI best serve your needs?     

Annual Membership Fee: 	Corporate Member:	$300Cdn X		=		Cdn	
(Please write down the amount)	Individual Member: 	$100Cdn X		=		Cdn	

Please forward the completed membership form and payment to:

Canada-China Society of Science & Technology Industries