Full Membership Form

Company Name *

Trading Name

Name That Should Appear on Membership Certificate (Co. Name OR t/a Name)

Date Formed *

Ownership *

Companies House Number

VAT Number

Charity Number

Mid Yorkshire Area *

Phone Number *

Generic Company Email Address *

Website

Address 1 *

Address 2

Address 3

County

Postcode *

Number of Full Time Equivalent Employees *

Sector *

Do You Require Your Membership To Become Immediately Active? *

Yes - I wish to take advantage of member benefits including export services immediately. My membership will start on 1st of current month.
No - My membership will start on 1st of next month

Do You Require A Purchase Order Reference To Be Included On Your Invoice? *

Yes
No

If Yes, Include The PO Reference Here

If You Have A 'trading/as' Name, Please State Name And Address Of What Should Appear On Invoice Here

Primary Contact First Name *

Primary Contact Surname *

Primary Contact Job Title *

Primary Contact Phone / Direct Line *

Primary Contact Email *

Accounts First Name *

Accounts Surname *

Accounts Job Title *

Accounts Phone / Direct Line *

Accounts Email *

Marketing First Name

Marketing Surname

Marketing Job Title

Marketing Phone / Direct Line

Marketing Email

HR First Name

HR Surname

HR Job Title

HR Phone / Direct Line

HR Email

Do You Export? *

Yes
No

Export First Name

Export Surname

Job Title

Phone Number

Email

Would you like your company details to be featured in the member directory, which is available to Mid Yorkshire Chamber Members only? *

Yes
No

Where did you hear about the Chamber? *

Please let us know who referred you

Please Give Any Further Details Here

Your privacy is important to us; the Mid Yorkshire Chamber is fully committed to complying with the provisions of the data protection act and EU GDPR. We restrict the access to personal data to trusted third parties with a legitimate business requirement, specifically those involved with providing member benefits. *

I accept

We confirm that we wish to apply for membership of the Mid Yorkshire Chamber of Commerce. We agree to abide by the terms and conditions as given in the Memorandum and Articles of the Association as found at my-chamber.co.uk. We understand that we will automatically receive a renewal invoice in the month prior to the annual anniversary of our membership. We accept that we are subject to a minimum notice period of 30 days prior to renewal to terminate our membership. *

I accept

Business Owner or Managing Director name *

First

Last

Job Title *

Business Owner or Managing Director Phone *

Business Owner or Managing Director Email *