Individual Associate* Corporate* Regional* Bi-National*

Company Representative to Chamber:

Title:

Division:

Name of Company:

Date Founded:

Sales Volume:

Employees:

Address:

City:

State:

Zip Code:

Telephone:

Extension:

Fax:

E-mail:

Website:

Type of Business:

Primary Marketing Areas:

Do you export?     Yes No

From:

To:

Do you have an office in Mexico?             Yes No

If yes, where in Mexico

Where is your headquarters?

Location of other offices:

Please enclose a paragraph with your corporate profile, including a company history description, your mission, a description of your products/services, and/or any promotional materials from your company:

Payment by check:


Make checks payable to: United States-Mexico Chamber of Commerce and
mail them to: 2 World Financial Center, 27th Floor, New York, NY 10281


Payment by credit card:


Fill out the following information and fax it to (212) 912-7714

Please charge my credit card: Amex MasterCard Visa
The amount of $

Name on credit card:

Credit Card Number:

Exp. Date:

Membership dues may be treated as legitimate business expenses
under the Internal Revenue Code.
For any questions, please feel free to call our office
at 212-912-7713 or contact us via e-mail at northeast@usmcoc.org