I request the British Chamber of Commerce and Industry in Brazil - Britcham examine and accept my application to be a Britcham member.

The information below is required and will be entered into Britcham's database. This information is confidential and authorisation will be obtained before it is published in the Members' Directory and other Britcham publications. I authorise the publication of my information in the Britcham website and publications I do not authorise the publication of my information in the Britcham website and publications

Full name
Profession
CPF	R.G./RNE
Street	District
City	State - AC AM AP AL BA CE DF ES GO MA MT MS MG PA PB PE PR PI RJ RN RS RO RR SC SP SE TO Post Code -
Telephone	Mobile
E-mail	Fax
Company	Website
Position
Areas of Interest:	Social Responsibility Economy Arbitration Finance and Economy Legislation Energy Health Marketing Environment Human Resources Taxing Ethics Insurance and reinsurance International Trade Tourism International Investment Logistics
Do you know any Britcham members that could provide references for your application? Yes No
Name: Contact information:

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