Application for Patron Membership

Application for Patron Membership
Date of Application*

DayMonthYear
Company Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*
Format: (000) 000-0000.
Sector*

AccountingArchitecture/ DesignBankingConstructionFinanceFood and beveragesGovernmentalHealth careICTIndustry/ ProductionLawLogistics and transportMarketing/ Communication/ PRReal estateRecruitmentResearch and developmentRetailTradeOther
Turnover
Are you registered for VAT?*

YesNo
VAT Number
Website
Please indicate which Social Media platforms you and/or your company uses.*

FacebookLinkedInTwitterYouTubeInstagramNoneOther
Main Contact
Full Name*

TitleFirst NameLast Name
Job Title*
Direct Line
Format: (000) 000-0000.
Email Address*
example@example.com
Please indicate your main language.*

DutchEnglishFrench
If there are employees you wish to add to our mailing list, please enter their names below.
Accounting Department
Email Address*
example@example.com
Membership Agreement
As a Patron Member you can enjoy all the services we provide to our Business Members, including exclusive access to all our business services, our business network and our events.

Additionally, we promote your business by:
- Putting your company logo on all the emails sent out by the BLCC team
- Putting your company logo on each page of the BLCC website
- Inviting you to exclusive Patron Members-only events with personal and direct access to high ranking professionals, business people, diplomats, academics and politicians
- Giving you priority for sponsoring and booking events
- Actively using your company as a preferred BLCC supplier for BLCC events and services
- Actively recommending your business to members and non-members
- Giving you a prestigious presence in the Belux community in the UK
Patron membership is ideal for larger companies who want to enjoy both Business and Club Class services, and who seek high visibility in the Anglo-Belux business community through our communication channels and activities.

Please note: Membership fees are for one year from date of invoice.
Please select your Membership.*

Patron Membership only - 3175 GBP + VATPatron Membership only - 3810 EUR + VATPatron Membership incl. Corporate Club Class Membership for 4 people - 5775 GBP + VATPatron Membership incl. Corporate Club Class Membership for 4 people - 6930 EUR + VAT
Please select the preferred type of payment.*

Electronic bank transferGoCardlessDirect Debit/ Domiciliëring/ Prélèvement Automatique
If Direct Debit, please select payment frequency.

One-off lump sumQuarterlyMonthly
If you have any comments or questions, please submit them here:
Please confirm your acceptance to the terms of our privacy policy - see footer of the BLCC website home page*

I agreeI do not agree
Should be Empty:

Application for Patron Membership

Main Contact

Accounting Department

Membership Agreement