TRADE EXCHANGE CANADA
MEMBERSHIP APPLICATION FORM

If you would like to become a member of the Trade Exchange Canada group of companies please fill out the following form and submit it to our membership department. One of our representatives will contact you to answer any questions you may have and get your account set up within 24 hours.


Business Identification:


Legal Business Name*
Cardholder Name to appear on card* (max 30 characters)

Company Name to appear on card* (max 30 characters)
Company Referred By

Business Address
City
Province
Postal Code

Business Phone*
Fax
Home Phone
Cellular Phone

E-Mail Address
Web Site Address
Corporation
 Proprietorship
 Individual
 Other 

Province of Incorporation
(if a corporation)
Number of Employees
Trade Broker

Directory Information:

Company Name to appear in Members' Directory
Listed 
Brokered 
 Listed 
Brokered 
 Listed 
Brokered 
Category listing in this directory
 Optional second category
 Optional third category

Please write a brief description (as you wish it to appear in the directory) of the types of goods/services your company provides or specializes in. (max 30 words)


Financial Information:

Please check here if you wish to pay by cheque or debit.

Otherwise, please fill in the information below for credit card payment.


Credit Card Type
Card Number
Name
    
 Expiry Date (mm/yy)
Billing Address (if different from above)

Billing Address

PLEASE READ CAREFULLY
By clicking the submit button, you hereby authorize Trade Exchange Canada Ltd. ("TEC") to debit funds from the credit card information provided above to cover fees detailed in the Membership Agreement.

"I have read and understand the Membership Agreement and agree to comply with the terms and conditions contained therein, as amended from time to time by TEC. This application is subject to acceptance by TEC."