Corporate Membership Form 100928

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German Australian Business Council e. V.
CORPORATE MEMBERSHIP APPLICATION FORM
(Please fax completed form to +49 (0)69 2727 2621)
Company:
Address:
Postcode:
Town/City:
Fax:
Website:
Country:
APPLICATION, RULES AND DATA PROTECTION
We hereby apply to become a corporate member of German Australian Business Council e. V
We have read the Articles of Association of German Australian Business Council e. V and agree to
be bound by its terms as a member.
We agree that company details and name(s), position(s) and contact details of the company contact(s)
as provided in this form or amended via email, fax or post to GABC from time to time may be published
in an electronic and / or a paper-form GABC Directory, which will be solely available to GABC members
and staff. We further agree that photograph(s) of company contact(s) taken at GABC events may
appear in GABC publications (e.g. newsletter) and / or on GABC internet site. GABC will not provide your
contact details to third parties other than GABC members or staff, without your express permission.
Signed on behalf of the
company by [ NAME ]
Date:
MEMBERSHIP FEE
The Corporate Membership fee is € 500.00 per year.
Please provide an invoice.
We hereby agree that German Australian Business Council e. V. will withdraw the yearly fee
from our account via direct debit (Einzugsermächtigung). This agreement can be cancelled at any
time by contacting German Australian Business Council (GABC) e.V. or its bank, Commerzbank Frankfurt.
Account No:
BLZ:
Bank:
Date:
Signature:
German Australian Business Council e.V.
Postfach 120143 | 60114 Frankfurt am Main | Fax: +49 (0)69 2727 2621 | Email: [email protected] | Website: www.gabc.eu
Konto 687 1800 00 | BLZ 500 400 00 | Commerzbank Frankfurt
Eingetragen im Vereinsregister des Amtsgerichts Frankfurt am Main unter VR 11212
CORPORATE NOMINEES
Corporate Membership entitles the company to select up to five nominees to attend events. Company
representatives can be changed at any time by notifying GABC by email, fax or post.
DATA PROTECTION
We agree that company details and name(s), position(s) and contact details of the company contact(s)
as provided in this form or amended via email, fax or post to GABC from time to time may be published
in an electronic and / or a paper-form GABC Directory, which will be solely available to GABC members
and staff. We further agree that photograph(s) of company contact(s) taken at GABC events may
appear in GABC publications (e.g. newsletter) and / or on GABC internet site. GABC will not provide your
contact details to third parties other than GABC members or staff, without your express permission.
Main Company Contact
Surname:
Given Name:
Mr/ Mrs/ Miss/ Ms/ Dr
Nationality:
Position:
Email:
Tel.No.::
Mobile:
Signature:
Industry Category No (see attachment*):
Second Nominee
Surname:
Given Name:
Mr/ Mrs/ Miss/ Ms/ Dr
Nationality:
Position:
Email:
Tel.No.::
Mobile:
Signature:
Third Nominee
Surname:
Given Name:
Mr/ Mrs/ Miss/ Ms/ Dr
Nationality:
Position:
Email:
Tel.No.::
Mobile:
Signature:
German Australian Business Council e.V.
Postfach 120143 | 60114 Frankfurt am Main | Fax: +49 (0)69 2727 2621 | Email: [email protected] | Website: www.gabc.eu
Konto 687 1800 00 | BLZ 500 400 00 | Commerzbank Frankfurt
Eingetragen im Vereinsregister des Amtsgerichts Frankfurt am Main unter VR 11212
Fourth Nominee
Surname:
Given Name:
Mr/ Mrs/ Miss/ Ms/ Dr
Nationality:
Position:
Email:
Tel.No.::
Mobile:
Signature:
Fifth Nominee
Surname:
Given Name:
Mr/ Mrs/ Miss/ Ms/ Dr
Nationality:
Position:
Email:
Tel.No.::
Mobile:
Signature:
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2
3
4
5
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7
8
9
10
11
12
13
14
Accounting
Advertising / PR
Agriculture
Banking (excl. Merchant Banking & Finance)
Building and Construction
Chemical & Plastics (incl. cosmetics and
pharmaceuticals)
Communications
Computer Services
Consultants
Employment Agencies
Energy (oil, gas, coal, solar, wind, nuclear)
Export / Import / Commerce
Finance (incl. Merchant Banking)
Food & Beverages (production, processing,
distribution)
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16
17
18
19
20
Insurance
Legal
Manufacturing
Mining & Mineral Treatment
Printing & Publishing
Property – Selling / Management
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23
24
25
26
27
28
Public Services
Removalists
Stockbrokers
Retailing
Textiles, Clothing & Footwear
Transport
Travel & Tourism
Other Products & Services (please specify in
the application form)
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German Australian Business Council e.V.
Postfach 120143 | 60114 Frankfurt am Main | Fax: +49 (0)69 2727 2621 | Email: [email protected] | Website: www.gabc.eu
Konto 687 1800 00 | BLZ 500 400 00 | Commerzbank Frankfurt
Eingetragen im Vereinsregister des Amtsgerichts Frankfurt am Main unter VR 11212