Individual Enrollment Form

Please complete the following form to enroll in the Canadian-Swiss Chamber of Commerce.

The correspondance information below corresponds to my:
Professional details or
Private details

First Name* :		Last Name* :
Name of Company :
Title :
Address* :		P.O. Box :
Zip code* :		Town* :
Telephone* :		Email* :
Natel :		Fax :
Website :
Note : please provide phone and fax as a string of numbers, without spaces or special characters - ex. 022 / 123 45 67 becomes 0221234567

Sponsored by :
Annual Membership Fee is CHF 85.-
Additional Comments :


* I have read, understood and will respect the terms of the CSCC By-Laws and Website Use Policy