LCOe - Membership Application - Lowveld Chamber Of eCommerce

Full Name

Please enter your full name as it appears on your ID or passport.

This field is required.

Email Address

Please enter a valid email address for correspondence.

This field is required.

Phone Number

Please enter a valid contact number including area code.

This field is required.

Company Name

Please provide the official name of your business.

This field is required.

Business Type

Select your business type from the list.

This field is required.

Business Registration Number

Enter your business registration number if applicable.

This field is required.

Address

Please provide your business address including street, city, and postal code.

Address Line 1

This field is required.

Address Line 2

This field is required.

City

This field is required.

State

This field is required.

Postal Code

This field is required.

Country

Website URL

Your business website URL (if applicable).

This field is required.

Membership Type

Select your preferred membership type.

Individual

Business

Non-Profit

Corporate

This field is required.

Comments or Questions

Feel free to ask any questions or comments you have about your application.

GDPR / POPIA Compliance

I confirm that I allow the Lowveld Chamber to store my data in compliance with GDPR regulations, and the POPIA, and The Electronics Communications and Transactions, and The Consumer Protection Acts, if and where applicable.
I understand that I may request my information be removed at anytime via email to:
compliance@lcoe.co.za

This field is required.