New Member Application
Membership fees are determined by size (number of fulltime employees in Northern California) and whether the corporation or its ultimate parent company is listed on a stock market. Annual fees will be prorated and invoiced along with a $50 ONE TIME PROCESSING FEE. Membership fees are non-refundable
Are you applying for:
*
Regular membership
Associate / Special Membership (Student, Scholar, Retiree only)
How did you learn about JCCNC?
*
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Name of Individual:
In Kanji, if applicable:
Phone Number
Please enter a valid phone number.
FAX Number
Please enter a valid phone number.
Email:
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Are you applying as a student?
Yes
No
Please enter your educational institution:
Upload your student ID here.
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Company Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Fax Number
Website
Total Number of Fulltime Employees
Summarized business description for directory (15 words or less)
0/16
Date of incorporation in USA
Primary Representative for JCCNC
First Name
Last Name
Primary Representative in Kanji
Primary Representative Title
Primary Representative E-mail Address
Business Category (Select all applicable)
Accounting
Banking
Consulting
Construction
Education
Electronics
Flight/Logistics/Transportation
Food/Beverage
Government/NPO
Insurance
Investment
Law
Manufacturing
Media
PC/Software
Real Estate
Restaurant
Sales/Services
Semiconductor
Technology
Telecommunications
Trading
Travel
Other
Parent Company Name (親会社)
Is Company or Parent Company listed on stock market?
Yes
No
Affiliated company abroad, if applicable:
Its address:
Nature of affiliation:
Subsidiary
Branch Office
Representative Office
Agent
Licensee
Other
If accepted, select any committees you'd be interested in joining :
Government Relations
Community Relations
Seminar Planning
Networking
Membership
Public Relations
Golf Tournament
New Year's Party
Interested but not decided yet
Additional names and email addresses who wish to receive JCCNC announcements. Please contact us if you'd like to add more than 8 names.
Name
Email
Japanese / English
1
Japanese
English
2
Japanese
English
3
Japanese
English
4
Japanese
English
5
Japanese
English
6
Japanese
English
7
Japanese
English
8
Japanese
English
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Applicant's Signature
Today's date
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Month
-
Day
Year
Date
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