M e m b e r s h i p R e p l a c e m e n t F o r m

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1 M e m b e r s h i p R e p l a c e m e n t F o r m Business Information Company Name: Member Category at AmCham: General Member Associate Resident Multinational Associate Non-Resident Not-For-Profit Affiliate (Principal member s signature is required for approval) Replacement Date: Member to be replaced: Member to be replaced title: New Appointee: New appointee title: (It has been an accepted practice that any Principal Member should be a senior executive, such as: CEO, Chairperson, Managing Director, Executive Director etc.) Management Level: Middle Management Top Management Year you joined the company: Location of employment (if outside Egypt): Corporate Address: Telephone Number(s): Ext: Fax: ---- Business General (e.g.info@domain.com): (This will be published in AmCham directory for any general inquiry to the company) I would like to receive all AmCham correspondence by: Fax Both Name of Personal Assistant: of Personal Assistant:

2 Personal Information Nationality: If from U.S. from which state: How many years have you been in Egypt? (if applicable): Birth Date (DD/MM/YYYY): Mobile Number (optional, will be used only in emergencies): Membership in other associations: Alexandria Business Association (ABA) British Egyptian Business Association (BEBA) Canada Egypt Business Council (CEBC) Canadian Chamber of Commerce in Egypt (CanCham) Egyptian Business Development Association (EBDA) Egyptian Businessmen s Association (EBA) Egyptian Junior Business Association (EJB) French Chamber of Commerce in Egypt (CCFE) German-Arab Chamber of Industry and Commerce (GACIC) Young Presidents' Organization (YPO) Other Business Associations (Kindly restrict to business associations only and write name of association in full): Charitable Organizations (Please specify and write name of organization in full): Preferred social media channel/ Your account (username/ ) Facebook: Twitter: LinkedIn: Google +:

3 What do you hope to gain from your membership at AmCham? How did you know about AmCham? Name of Spouse: Hobbies: Dietary Restrictions: Applicant s Signature: For Affiliate members, the Principal Member s signature is required for approval: Principal Member s Signature: Date: -- NOTE: A COLORED PICTURE OF THE NEWLY-APPOINTED MEMBER, CV, AND A COPY OF A VALID NATIONAL ID OR A COPY OF A VALID PASSPORT IS REQUIRED. Please send the form by membership@amcham.org.eg or by fax on N.B. Subject to Board approval 3

4 A M C H A M C O M M I T T E E S AmCham Egypt's 21 committees represent diverse sectors and industries, and provide a forum for AmCham members to raise issues about the business climate. Prominent guest speakers from the government, international agencies, and the private sector are invited as speakers to address the Committees. P l e a s e m a r k y o u r p r e f e r r e d c o m m i t t e e ( s ) To help us in communicating with you the upcoming committee meetings 1. ( ) Agriculture and Food Security 2. ( ) Banking and Finance 3. ( ) Capital Market 4. ( ) Corporate Sustainability & Responsibility (CSR) 5. ( ) Customs & Taxation 6. ( ) Education 7. ( ) Energy 8. ( ) Entrepreneurship and Innovation 9. ( ) Health & Pharmaceuticals 10. ( ) Human Resources 11. ( ) Industry & Trade 12. ( ) Information & Communications Technology (ICT) 13. ( ) Insurance 14. ( ) International Cooperation 15. ( ) Investment 16. ( ) Legal Affairs 17. ( ) Marketing 18. ( ) Real Estate 19. ( ) Transport & Logistics 20. ( ) Travel & Tourism 21. ( ) Women in Business 4

5 Please mark in front of what you are interested in from the following AmCham services: Networking AmCham Events Advocacy AmCham Committees Information Business Monthly Business Studies (BSAC) Business Inquiries Tenders Alert Service (TAS) Exposure Events Sponsorship AmCham Website AmCham Directory AmCham Calendar Quality Benefits Program Partnership Opportunities Business Matchmaking Career Enhancement International Professional Certifications Training Workshops Computer Courses Recruitment Services Employment Fair Online Training Service (OTS) Cost-cutting services Videoconferencing Website and Intranet Development Thank you 5

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