Membership Application Form
Unit 117, 5200 Dixie Road, Mississauga, ON L4W 1E4
Tel: 905-625-6222  
E-mail: mcba@mcba-canada.com
Website: mcba-canada.com

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Name of Applicant *
Contact Phone No. *
Name of Business *
No. of Employees *
Mailing Address *
City *
Postal Code *
Address
(if Residence/Business is Different then then Above)
City
(if Residence/Business is Different then then Above)
Postal Code
(if Residence/Business is Different then then Above)
Business Telephone
Fax
Email *
I agree to give permission to Mississauga Chinese Business Association to send me emails and electronic messages containing notices, event information, invitations and similar communications and to use my name and picture in any media including broadcast, telecast, newsletters, newspapers and program books.  I agree to waive, release and not pursue any claims whatsoever against Mississauga Chinese Business Association, its directors, volunteers or employees for any loss, damage or injury incurred for the messages and publications above; and for attending any and all events arranged by the said Association. *
Obrigatória
Signature and Verified By Applicant
Please type in your name
Date
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