Membership application form of the Belgian-Luxembourg Chamber of Commerce in Russia

Full membership - to act and succeed together!

Please complete this Application Form / Пожалуйста заполните данную анкету-заявление
Date of Application *

Day Month Year
Contact Details:
Name *

Title First Name Last Name
Job Title *
Direct Line *

Country Code Phone Number
Mobile Number

Country Code Phone Number
Email Address *
example@example.com
Please indicate your main language: *

Dutch English French Russian
Company Details:
Company Name *
Address *

Street Address

Street Address Line 2

City State

Zip Code Country
Type a question *

Accounting Architecture/ Design Banking Construction Finance Food and beverages Governmental Health care ICT Industry/ Production Law Logistics and transport Marketing/ Communication/ PR Real estate Recruitment Research and development Retail Trade
Website
Please select your Membership Category for 12 months *
The category is determined according to the size and turnover of the company. As a Full Member you have exclusive access to all our events, our business network, and business trade delegations and missions. Please note: Membership fees are for one year from date of invoice
Accounting Department Email *
example@example.com
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