Join Us Registration Form "*" indicates required fields Step 1 of 6 16% 1. Personal DetailsThese details will identify you as the admin of your organisation’s account. By registering with these details, you will be the sole controller of your organisation’s membership account. Others will be able to access your organisation’s account but they will have restricted access to certain parts.Name* First Name* Last Name* Work Email Address** Job Title**Telephone Number** 2. Organisation Contact DetailsOrganisation Name**Organisation AddressAddress Line 1**Address Line 2Address Line 3Postcode**City/Town**Select County**ArmaghDownAntrimL ‘DerryTyroneFermanaghOtherCountryIf you selected 'Other' please write below.*Invoice AddressSame as Organisation Address Same as Organisation Address Address Line 1**Address Line 2Address Line 3Postcode**City/Town**Select County**ArmaghDownAntrimL ‘DerryTyroneFermanaghOtherCountryIf you selected 'Other' please write below. 3. Organisation DetailsOrganisation Email Address**Organisation Website**Organisation Telephone Number**Organisation VAT NumberOrganisation Annual TurnoverOrganisation Export %Nature of Business**Number of Years TradingSectorAgri-foodBusiness Management ConsultantsBusiness ServicesComputer & Related ActivitiesConstructionCreative IndustryEducationElectricity, Gas & Water SupplyFinancial and Legal ServicesHealth & Social WorkITManufacturing and EngineeringMarketing and Public RelationsMining & QuarryingOtherPublic Administration & DefenceReal Estate Renting & Business ActivitiesTelecommunicationsTourismTransport Storage & CommunicationUnknownWholesale & Retail TradeNumber of Employees0-910-4950-250>250Sole TraderSocial Media LinksFacebookTwitterInstagramYoutubeLinkedIn 4. Additional Contact InformationPlease complete any additional contact names belowPrimary ContactPrimary Contact is me Primary Contact is me First Name**Last Name**Job Title**Email Address**Finance ContactFirst NameLast NameJob TitleAccounts Payable Email AddressMarketing/PR ContactFirst NameLast NameJob TitleEmail AddressAdditional ContactFirst NameLast NameJob TitleEmail Address 5. Membership and PaymentMembership Type** Essential Membership Annual Fee £744 (£620 + VAT) Growth Membership Annual Fee £1,890 (£1,575 + VAT) Corporate Membership Annual Fee £3,780 (£3,150 + VAT) Membership Type** Growth Membership Annual Fee £1,890 (£1,575 + VAT) Corporate Membership Annual Fee £3,780 (£3,150 + VAT) Membership Type** Corporate Membership Annual Fee £3,780 (£3,150 + VAT) Payment Method**Membership will be activated when payment or Direct Debit have been received. Payment will be taken by Credit/Debit Card when you select ‘Ready to Join?’ Credit/Debit Card Direct Debit Membership will not be activated until an authorised Direct Debit mandate is received by our Finance Department at accounts@northernirelandchamber.com Invoice with Official Purchase Order No. Membership will not be activated until the invoice is paid in full. Payment Frequency* Annual Monthly (12 payments) – Direct Debit only Last StepWhere did you hear about the Northern Ireland Chamber of Commerce and Industry?Please Select OneNI Chamber WebsiteSocial MediaEventEmailRecommendationSearch EngineOther(If you selected 'other', please provide more information below)To complete the registration process tick the box below:* I am an authorised representative of the before mentioned organisation. By ticking this box, the organisation agrees to the T&Cs that can be found here.*
