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Registration Form

Company: Address:
C.E.O. Name: Company Rep:
Tel No:  Fax No:
E-Mail: Email 2:
Website:
Year Established:

Number of Employee(s)

Members Group :

List Products :

# Product Name   Brand Name
Item # 1:   
Item # 2:   
Item # 3:   
Item # 4:   
Item # 5:   
# TOTAL PRODUCTION- DOMESTIC (UNITS): TOTAL PRODUCTION-  EXPORT (UNITS): GROSS ANNUAL SALES DOMESTIC: $Ja. GROSS ANNUAL SALES EXPORT: $Ja
Item # 1:
Item # 2:
Item # 3:
Item # 4:
Item # 5:

 

PROPOSERS/REFERENCE (past or current member of the JMA)

NAME: ADDRESS:
NAME: ADDRESS:

 

 General Info :