Corporate Application

Monte Jade Science and Technology (Southeastern U.S.)

Corporate Membership Application/Renewal Form

NAME OF COMPANY			DATE
PHONE		FAX
ADDRESS
MAJOR CONTACT PERSON	NAME IN CHINESE	NAME IN ENGLISH	POSITION
	BUSINESS PHONE	RESIDENT PHONE	FAX
PRIMARY BUSINESS
NUMBER OF EMPLOYEE		[ ] 9 OR FEWER	[ ] 10 OR MORE
REPRESENTATIVE BESIDES MAJOR CONTACT PERSON	NAME IN CHINESE	NAME IN ENGLISH	POSITION
	BUSINESS PHONE	RESIDENT PHONE	FAX
	NAME IN CHINESE	NAME IN ENGLISH	POSITION
	BUSINESS PHONE	RESIDENT PHONE	FAX
EXPECTATION
AVAILABLE SUPPORT

$100.00-Silver Membership, $250-Gold Membership, $500-Platinum Membership
Please complete this form and send with membership fee payment to: Mr. Li Wang, 5156 Broadgreen Dr, Norcross, GA 30092
Please make check payable to: Monte Jade Science and Technology Association (Southeaster US)
Please notify us of your facsimile number changes as soon as possible.