Panamanian American Chamber of Commerce

2500 NW 79 Avenue (Miami Free Zone)

Suite 180

Doral, FL 33122

Phone: (786)394 0981    E-Mail: panamachamber@aol.com

City of Doral: http://www.cityofdoral.com/cityofdoral

MEMBERSHIP APPLICATION

Please print and mail this application along with your check to:

Panamanian American Chamber of Commerce

2500 NW 79 Avenue (Miami Free Zone)

Suite 180

Doral, FL 33122

or you may pay with your credit/debit card at PayPal

 using the buttons at the end of the page

Name or Company Name : _________________________________________

Representative (s): ________________________________________________

Tittle(s): ________________________________________________________

Address:________________________________________________________

City: _______________        State: __________        Zip: ________________

Phone: _________________________    Cell: __________________________   

Fax: ___________________________ E-mail:__________________________  

 The Undersigned hereby applies for membership in the Panamanian  American Chamber of Commerce of Florida, and declares that the applicant subscribes to the aims and purposes of the said Chamber as set forth in the bylaws of the Chamber.

   Membership Type: ____________________________________________

   Signed __________________________________       Date : __________

Membership Cost:

Students :        $  50.00

Personal :         $100.00

Corporate :    $ 250.00

Trustee:           $ 500.00