Membership Application

Name of Organization: _____________________________________

Address: __________________________________________________

City: ___________________________ State:_____________ Zip: _____________

Chairman's Name: ______________________________________________________

President's Name: __________________________________________________

CEO's Name (if not one of the above): __________________________________



The following individual is designated as the contact person:

Name: ___________________________________________________

Title: __________________________________________________

Mailing Address:__________________________________________________

City: ___________________________ State:_____________ Zip: _____________

Phone: (______) ______________ Fax: (______) ______________

e-mail: ___________________________ Web site address:________________________

Enclosed is our check (number) ____________ in the amount of $3,000.00 for our
Annual Membership Dues in the Corporate Council on Africa.*



(signature)__________________________________ (title) _____________________(date) _______________

Please return to:
The Corporate Council on Africa
1660 L Street, N.W.
Suite 301
Washington, D.C. 20036
(202) 835-1115
Fax: (202) 835-1117

*Good for 12 months commencing the month we deposit your check.











For the long term, The Corporate Council on Africa needs to know the distribution of its members' interests in the U.S. - African business relationship. This knowledge will enable the Council to better meet the needs of its members, not only in terms of detailed program planning, but also guiding the evolution within the confines of its stated mission-of this dynamic organization.

Please take a few minutes to answer the following questions, and return this with your application form.

1. Describe briefly your organization's current interests in or its current business relationship with Africa, including specific countries with which your organization is involved.





2. Please describe your organization's goals for starting a business relationship with Africa, expanding current activities, or starting new ones. (Itemize specific countries, if possible.)





3. How can The Corporate Corporate Council on Africa assist your organization's business goals in Africa?