Members Application - American Chamber

Member Application

General Information and Contact

Name *

Email *

Contact Number

Website

Joined On

Company Logo *

Add Image

Title

Alternative Text

Leave empty if the image is purely decorative.

Caption

Description

Mailing Address

Invoicing/billing address if different from mailing address

Representative

Designate Name *

Designate Position

Designate Nationality

Designate Phone

Designate Email

Alternate Name *

Alternate Position

Alternate Nationality

Alternate Phone

Alternate Email

Operation Information

Date established in Guyana

Date established in the USA/worldwide

Type of legal entity

How do you characterize your organization?

Current number of employees in Guyana

Please state annual gross revenue

Nature of business conducted in Guyana

Trade or business interests with the USA

Do you wish to be included in AmCham Guyana’s Directory of Members?
Do you wish for your contact information to be made publicly available?

Membership Category & Fees

Once approved, membership fees are not refundable.

Category	Revenue	Dues
A	$3B+	$700,000 GYD
B	$300M – $3B	$500,000 GYD
C	$50M – $300M	$200,000 GYD
D	$5M – $50M	$90,000 GYD

References/Evidence of Good Standing

How did you learn about AmCham Guyana?

Please provide the name of the member or administrative officer recommending your membership

Please provide a copy of your company profile:

File name:

File size:

Add File

Title

Alternative Text

Leave empty if the image is purely decorative.

Caption

Description

Please provide a copy of the company’s registration in Guyana:

File name:

File size:

Add File

Title

Alternative Text

Leave empty if the image is purely decorative.

Caption

Description

Please provide a copy of the company’s Tax Identification Number (TIN) certificate:

File name:

File size:

Add File

Title

Alternative Text

Leave empty if the image is purely decorative.

Caption

Description

Please provide a copy of the company’s National Insurance Scheme Registration (NIS):

File name:

File size:

Add File

Title

Alternative Text

Leave empty if the image is purely decorative.

Caption

Description

Financial Statement/Projected Cash Flow:

File name:

File size:

Add File

Title

Alternative Text

Leave empty if the image is purely decorative.

Caption

Description