MEMBERSHIP APPLICATION FORM

APPLICATION INSTRUCTIONS 1. PLEASE COMPLETE APPLICATION QUESTIONS FIELDS (I-XI). 2. PLEASE ENCLOSE DUES PAYMENT WITH APPLICATION OR MARK PLEASE BILL BOX BELOW. DUES AND COMPANY INFORMATION I. ELIGIBILITY
MEMBERSHIP IN THE U.S.- BAHRAIN BUSINESS COUNCIL IS AVAILABLE TO AMERICAN BUSINESS CORPORATIONS OR OTHER BUSINESS ENTITITES INCORPORATED IN THE UNITED STATES THAT CURRENTLY PERFORM OR POSSESS THE CAPACITY TO DO BUSINESS DIRECTLY WITH THE COUNTRY OF BAHRAIN. FOREIGN COMPANIES MAY ALSO BE ELIGIBLE FOR MEMBERSHIP BASED ON THE MEMBERSHIP GUIDELINES PROVIDED IN THE COUNCILS BYLAWS.

II. ANNUAL DUES

MEMBERSHIP DUES ARE INVOICED ON THE FIRST DAY OF THE MONTH FOLLOWING RECEIPT OF THIS FORM AND COVER A FULL 12 MONTH PERIOD FROM THE DATE OF INVOICE.

CHAIRMANS CIRCLE MEMBER* $10,000 CORPORATE* $ 5,000 ASSOCIATE CORPORATE* $ 3,000 AFFILIATE* $ 1,000
UNDER FEDERAL TAX INCOME RULES, USBBC MEMBERSHIP DUES ARE NOT DEDUCTIBLE AS CHARITABLE CONTRIBUTIONS. PER INTERNAL REVENUE SERVICE GUIDELINES, ABOUT 70% OF USBBC DUES ARE TAX DEDUCTIBLE. PAYMENT INFORMATION IS ON THE FINAL PAGE.

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*membership levels:
A. Chairmans Circle Members. Chairmans Circle Members Will Have Additional Benefits Of: 1) Increased Visibility For Company Branding On The U.S.-bahrain Business Council Electronic Letterhead, 2) Increased Visibility For Company Branding By Designation As Chairmans Circle Member On The U.S.-bahrain Business Council Website, And 3) Priority Seating At All Events, Programs, And Activities Conducted By The Council, In Addition To All Corporate Member Benefits. B. Corporate members. Corporate members are, by virtue of their membership status, eligible for membership on the Board of Directors. Bahraini firms that have substantial business activity and interest in the United States, but that would not otherwise be eligible for corporate membership in the U. S. Bahrain Business Council may become members of the Council if a majority of the Board of Directors agree and vote that such membership is in the interest of the Council and is consistent with the Councils purpose as defined in its mission statement. However, such Bahraini firms (with the exception of Founding Corporate Members) will not have membership on the Board of Directors except as agreed and voted on by a majority of the board members. C. Associate Corporate Members. Associate Corporate members are not entitled to Board of Directors eligibility. Associate Corporate members may become eligible for membership on the Board of Directors by elevating their membership classification to Corporate Member. Associate Corporate members are also invited to all of the Councils events and have access to the Councils resources. D. Affiliate Members. By invitation of the Board of Directors, non-profit organizations may be offered membership without charge as Affiliate Members of the Council. Affiliate Members shall not have board eligibility under any circumstances.

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III. COMPANY INFORMATION

NAME OF FIRM: HEADQUARTERS ADDRESS: CITY: TELEPHONE: WEBSITE URL:

STATE: FAX:

ZIP CODE:

PARENT COMPANY: HEADQUARTERS ADDRESS: CITY: TELEPHONE: WEBSITE URL:

STATE: FAX:

ZIP CODE:

APPROXIMATE ANNUAL REVENUE: REVENUE GENERATED FROM GCC COUNTRIES: MAIN BANKERS:

DESCRIPTION OF THE COMPANYS OVERALL BUSINESS:

PLEASE LIST THE COMPANYS PRINCIPAL PRODUCT/SERVICE INTERESTS IN BAHRAIN

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IV. PRIMARY CONTACT

PLEASE PROVIDE INFORMATION ON COMPANYS PRINCIPAL REPRESENTATIVE FOR BAHRAIN BUSINESS TO WHOM ALL SENIOR LEVEL COMMUNICATIONS, INQUIRIES, AND MEMBERSHIP NOTICES FROM USBBC SHOULD BE ADDRESSED.

CONTACT INFORMATION

NAME: TITLE: COMPANY: ADDRESS: CITY: TELEPHONE: EMAIL ID:

STATE: FAX:

ZIP CODE:

V. COUNTRY MANAGER
NAME: TITLE: COMPANY: ADDRESS: CITY: TELEPHONE: EMAIL ID:

STATE: FAX:

ZIP CODE:

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VI. GOVERNMENT RELATIONS CONTACT (IF APPLICABLE)

NAME: TITLE: COMPANY: ADDRESS: CITY: TELEPHONE: EMAIL ID:

STATE: FAX:

ZIP CODE:

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VII. ADDITIONAL CONTACTS (IF APPLICABLE)

NAME TITLE COMPANY: ADDRESS: CITY: TELEPHONE: EMAIL ID:

STATE: FAX:

ZIP CODE:

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NAME: TITLE: COMPANY: ADDRESS: CITY: TELEPHONE: EMAIL ID:

STATE: FAX:

ZIP CODE:

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NAME: TITLE: COMPANY: ADDRESS: CITY: TELEPHONE: EMAIL ID:

STATE: FAX:

ZIP CODE:

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VIII. SECTORS OF INTEREST

PLEASE INDICATE YOUR COMPANYS INTERESTS: DEFENSE ENERGY FINANCIAL SERVICES TELECOMMUNICATIONS AVIATION HEALTH CARE IMPORT/EXPORT INFORMATION TECHNOLOGY INSURANCE & PENSIONS INTELLECTUAL PROPERTY LIFE SCIENCES MANUFACTURING TRANSPORT & INFRASTRUCTURE TOURISM AND HOSPITALITY MEDIA & ENTERTAINMENT LEGAL & ACCOUNTING SERVICES REAL ESTATE/DEVELOPMENT RETAIL TAXATION

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IX. STATEMENT OF INTEREST

PLEASE GIVE A DESCRIPTION OF YOUR COMPANYS INTEREST IN JOINING THE USBBC:

X. RECOMMENDING MEMBER NAME

PLEASE GIVE THE NAME OF THE U.S.-BAHRAIN BUSINESS COUNCIL MEMBER (IF APPLICABLE) THAT HAS RECOMMENDED YOUR COMPANY:

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XI. PAYMENT INFORMATION

PLEASE PROVIDE INFORMATION ON THE CONTACT PERSON FOR ANNUAL DUES PAYMENTS. IF DUES ARE SPLIT BETWEEN SEPARATE OFFICES, PLEASE ATTACH BACKSHEET WITH COMPLETE CONTACT DETAILS AND PAYMENT BREAKDOWN. NAME: TITLE: COMPANY: ADDRESS: CITY: TELEPHONE: EMAIL ID:

STATE: FAX:

ZIP CODE:

PLEASE SEND INVOICE TO DUES CONTACT PAYMENT BY CHECK: CHECK SENT SEPARATELY PAYMENT BY CREDIT CARD CREDIT CARD NUMBER: CREDIT CARD TYPE: SIGNATURE:

VISA MASTERCARD

EXPIRATION DATE: AMERICAN EXPRESS DATE:

DISCOVER

PLEASE MAKE PAYMENT OF ANNUAL DUES PAYABLE TO: U.S. CHAMBER OF COMMERCE SEND APPLICATION TO: U.S. CHAMBER OF COMMERCE U.S.- BAHRAIN BUSINESS COUNCIL

1615 H STREET, NW WASHINGTON, DC 20062 202 463 3114 (FAX) - PLEASE INCLUDE THE INVOICE WHEN MAILING YOUR CHECK

NOTE

U.S.- BAHRAIN BUSINESS COUNCIL 1615 H STREET, NW WASHINGTON, DC 202 463 5401 (TEL) 202 463 3114 (FAX)

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