AusCham Office Use Only

Date received:/ /

Member Code:

NATIONAL CHARITYMEMBERSHIP APPLICATION FORM

MEMBERSHIP TYPE (12months)
Membership Category / CHARITY (Non Voting)
ABN (Australian Business Number) or Investment License Number
Issue date (dd/mm/yyyy):
Issuedby: / ………………………………………………………..
-----/-----/------
………………………………………………………..
Please describe your links to Australia
(please check all categories that are applicable) / Australian citizen
Lived in Australia for … years
Works for an Australian company, or for a Vietnamese enterprise whose shareholding (equity) is owned by an Australian company/individual
Works for the Australian Government
Australian clients/business partners
Other (please specify below)
………………………………………………………………………………………………………

COMPANY DETAILS

Company Name
Company Short Name for Membership Card(if any)
Company Address
Email Address
Company Telephone / Fax:
Company Website
Investment Type / 100% Foreign Owned
BCC Partner (foreign)
Representative office
Vietnamese Company
Joint Venture Company / BCC Partner (Vietnamese)
Government/Embassy
Foreign Contractor
Other (please provide details below)
………………………………………………...
Business Activity / Government
Accounting - Advisiory - Tax
Advertising
Agriculture
Airlines
Automobile
Banking & Finance
Business Consulting
Construction & Architecture
Education & Training
Engineering
Entertainment
Government of Australia
Healthcare
Hospitality
Human Resources Consulting
Industrial park
Information Technology / Infrastruture
Insurance
Land Clearance and Consultancy
Legal
Logistics - Moving & Relocation
Manufacturing
Market Research
Marketing – Customer Services
Media
Mining
NGO
Passive Telecommunications Equipment
Petroleum
Real Estate
Recruitment
Retails
Tourism
Others (please provide details)
1st NOMINEE DETAILS
Mr/Mrs/Miss/Ms/Dr / Title:
Short Name for Membership Card(if it is different from first name)
Nationality
Date of Birth
Office Address (if it is different from company address)
Office Tel / Mobile:
E-mail
2nd NOMINEE DETAILS
Mr/Mrs/Miss/Ms/Dr / Title:
Short Name for Membership Card (if it is different from first name)
Nationality
Date of Birth
Office Address (if it is different from company address)
Office Tel / Mobile:
E-mail
3rd NOMINEE DETAILS
Mr/Mrs/Miss/Ms/Dr / Title:
Short Name for Membership Card(if it is different from first name)
Nationality
Date of Birth
Office Address (if it is different from company address)
Office Tel / Mobile:
E-mail
Company Profile for AusCham’s Online Members’ Directory
Please provide business details, objectives and your message for AusCham’s online Members’ Directory. Your company profile page can only be viewed by fellow AusCham Members.
Profiles for Corporate / SME Members, as full members, are filed under their business names which can also be searched for by industry classification.

AusCham will confirm the category of membership with the applicant prior to payment of membership fee. Processing of the fee shall be taken as confirmation that the applicant accepts the category of membership recorded by AusCham. A member may apply to have its category of membership reviewed if it submits a written application detailing relevant reasons.

Please note: Corporate Ordinary Memberships may have a maximum of three nominees with voting rights. The CorporateOrdinary Member may apply for additional nominees to be added to itsMembership but those nominee(s) will NOT enjoy any voting rights.

Declaration: I agree to be bound by the Charter and rules of the Australian Chamber of Commerce Vietnam.

Signed: ______Date: ______

Please send your corporate profile, logo and licence as well as scanned passport image and portrait photo of nominee(s) to

/ AUSTRALIAN CHAMBER OF COMMERCE, VIETNAM
NATIONAL CORPORATE MEMBERSHIP FEE
No / Category / Annual Fee / Each nominee
From 4th (except from 3rd for SMEs)
1. / CORPORATE MEMBERSHIP (Transferable) / 12.700.000 / 1.100.000
Ordinary Corporate Member - Legal entities operatingor having agencies in Vietnam which have substantial Australia ties. (Voting)
 Associate Corporate Member - Non Australian Companies that can demonstrate a business link to Australia or Australian business in Vietnam (Non-voting)
Non-Resident Associate Corporate Member - Australian or non-Australian companies with substantial business links to Australia or Vietnam located outside of Vietnam.(Non-voting) / 6.500.000 / 650.000
2. / Small and Medium Enterprise (SME) Membership – less than 20 employees (Transferable) / 8.800.000 / 1.100.000
Ordinary SME Member – Legal entities operating or having agenciesin Vietnam which have substantial Australia ties. (Voting)
 Associate SMEMember – Non Australian Companies that can demonstrate a business link to Australia or Australian business in Vietnam (Non-voting)
Non-Resident SME Member - Australian or non-Australian companies with substantial business links to Australia or Vietnam located outside of Vietnam. (Non-voting) / 4.400.000 / 1.100.000
3. / CHARITY – legal non-governmental organisation which has substantial ties to Australia, 2 non-voting employee nominees. (Non-voting) / 1.100.000 / 450.000

If you have any further questions, please contact AusCham office at: r Tel: +84 8 3832 9912

PAYMENT BY: / Please select your preferred method of payment. We will then forward payment instructions separately.
Cash
Bank transfer
Credit Card:
VISA Master Card

The Australian Chamber of Commerce in Vietnam (AusCham)is an independent, not for profit, membership-based NGO (non government organisation). It does not receive any funding from the Australian Government or any of its agencies. Its revenue is generated through memberships, sponsorships, events and advertising.