american chamber of commerce in romania

(AmCham Romania)
Union International Center 4th Floor - 11, Ion Campineanu, Bucharest 1 - Romania
T: + 40 21 315 8694, + 40 21 312 4834, + 40 31 2amcham (262426) F: + 40 21 312 4851
/www.amcham.ro

Applicant Information

Company Name[1]:
Official name and incorporation form:
Fill in the following information if applicable:
Name of US/International Affiliates:
Subsidiary of:
(name & place of incorporation)
Shareholding structure:
Publicly listed on Stock Exchange:
Mailing address
City: / Street: / ZIP Code:
Address details: / County/District:
Phone 1: / Fax 1: / www.
Phone2: / Fax 2: / Office email:

Financial details

Trade Register Number: / Fiscal Code:
Bank account (IBAN): / Bank:

CONTACTS

Contact details of company team members to receive AmCham communication. Information will be used for AmCham only, will not be publicly displayed or disclosed to third parties.
CEO: / Position:
Phone: / Mobile: / E-mail:
CFO: / Position:
Phone: / Mobile: / Email:
HR: / Position:
Phone: / Mobile: / Email:
MK: / Position:
Phone: / Mobile: / Email:
Sales: / Position:
Phone: / Mobile: / Email:
Corporate Affairs: / Position:
Phone: / Mobile: / Email:
LEGAL: / Position:
Phone: / Mobile: / Email:
PR Name: / Position:
Phone: / Mobile: / Email:
CEO Assistant:
Phone: / Mobile: / Email:
AmCham Contact Person – The AmCham contact person is designated by the affiliated company to the point of contact for AmCham in relation with the company.
Name & Position:
Phone: / Mobile: / Email:

Business field

Please check one that applies or fill in the “Others” field:
Advertising Marketing Promotion/PR Agriculture Audit Accounting Tax Automotive/Cars Banks
Insurance Financial Services Constructions Consultancy FMCG Education/Training Energy Environment Food/Beverages Healthcare/Pharmaceutical Hospitability/Travelling HR Consulting/Recruiting/ Executive Search ICT Investment/Capital Markets Legal Services Machinery/Tools Media Non Profit Oil Industry Real Estate Security/Defence Transportation/Relocation
Others:

additional INformation

Year of incorporation in Romania: / Number of employees worldwide:
Total investments in Romania (USD): / Number of employees in Romania:
Previous Year Turnover (USD):

TYPE OF MEMBERSHIP

Corporate - for companies with an annual global turnover over 5 mil USD
Annual Fee: 6,600 lei One time joining fee: 330 lei
Business – for companies with an annual global turnover below 5 mil USD
Annual Fee: 2,310 lei One time joining fee: 330 lei
Non-Profit
Annual Fee: 1000 lei One time joining fee: 330 lei
Individual – for individuals not affiliated with a company in Romania (freelancers)
Annual Fee: 1,300 lei One time joining fee: 330 lei

company profile

Please provide a 100 words company profile to be included in the AmCham’s publications (electronic newsletter and Membership Directory)
Important About the Application Process to AmCham Romania
All fields, unless specified, are requested. The application for membership will also include two recommendations from current AmCham Romania members. The support messages will be submitted via mail or email to , will be worded in English and signed by top management representatives of the supporting companies.
Complete applications for membership (filled-in application form and two recommendations letters from current AmCham Romania members) will be reviewed for approval by the AmCham Romania Board of Directors during their monthly meetings.
TERMS AND CONDITIONS
I, the here below undersigned hereby execute on behalf of the Company having full authorization to do so according to the statutes and legislation governing third party representation, the following affidavit: (i) I understand that executing the current application form on behalf of the Company constitutes legal and binding consent of the Company to the storing and processing of (a) the Company’s corporate information and (b) the Company employee’s information by AmCham Romania in a manner legally appropriate with the hereto request for affiliation; (ii) I understand that only complete documentation will be processed for the Board’s evaluation and approval and hereby state that all information provided herewith is accurate and up to date, having been legally obtained and disclosed to AmCham Romania; (iii) The present affiliation form, once approved by the AmCham Romania Board of Directors, represents a binding agreement between the parties and the Company becomes a member of the American Chamber of Commerce in Romania as soon as the membership fee is paid in AmCham Romania’s bank account; (iv) I understand that membership with AmCham Romania does not give me or the Company any representation rights on behalf of AmCham Romania (including but not limited to (a) right to represent and speak on behalf of AmCham Romania or (b) issue any written and/or verbal statements binding or in the name or on behalf of AmCham Romania) unless otherwise expressly provided in written by the AmCham Romania Board of Directors or their proxies and/or attorneys; (v) I understand that failure to observe the covenant provided under point (iv) here above could lead to immediate exclusion from AmCham Romania affiliate directory and termination of membership.
Applicant signature and stamp
Company:
Name:
Position:
Signature: / Date:
Stamp:

1

[1] Hereinafter referred to as the “Company”.