Professional Documents
Culture Documents
Admission Form Professional Member: Page 1 of 3 To Be Completed by The Member
Admission Form Professional Member: Page 1 of 3 To Be Completed by The Member
ADMISSION FORM
International Headquarters
7, rue d'Aumale - 75009 - Paris - France
Email: admission@chaine-des-rotisseurs.net
Tel: +33 1 42 81 30 12 Fax: +33 1 40 16 81 85
PROFESSIONAL MEMBER
Page 1 of 3
PERSONAL INFORMATION*
LAST NAME
PASSWORD
Month
GENDER
Female
Year
PROFESSIONAL INFORMATION*
Male
Professional Status
Position (Occupation)
BUSINESS ADDRESS*
City/Suburb
State/Province
Tel N
Email
Country
Mobile N
Fax N
Website
HOME ADDRESS
N + Street/Avenue (etc.)
City/Suburb
State/ Province
Mobile N
Tel N
HOME
BUSINESS
HOME
BUSINESS
ADMISSION FORM
International Headquarters
7, rue d'Aumale - 75009 - Paris - France
Email: admission@chaine-des-rotisseurs.net
Tel: +33 1 42 81 30 12 Fax: +33 1 40 16 81 85
PROFESSIONAL MEMBER
Page 2 of 3
ESTABLISHMENT INFORMATION*
Establishment Type
Traditional
French
Number of Covers
(Restaurant capacity/seats)
International
Italian
Asian
Benefits
Offered
No
Yes
Yes
No
Yes
Will you display the Ordre Mondial des Gourmets Dgustateurs plaque?
Credit Cards Accepted?
(Select at least one)
American Express
VISA
MasterCard
No
JCB
Diners Club
None
Additional Information
(not addressed above that you wish to
communicate to members and for other
establishment types)
Languages Spoken
(Select at least 1)
Yes
No
Last Name
First Name
CHAINE FOUNDATION (ACCR) DONATION (OPTIONAL) - Note: Minimum donation amount : 5.00*
to the Chane Foundation (ACCR).
Credit Card
Expiry Month
Cash
Cheque
Bank Transfer
Invoice Required
Yes
Card N
Year
Security Code
I confirm that the information provided is correct and agree to fully adhere to the International By-Laws and the rules and
regulations of the Chane des Rtisseurs, without reservation.
Date*
By submitting this application, I accept to comply
Yes
No
Day
Month
Year
with the rules and conditions of membership*
First Name*
No
Last Name*
ADMISSION FORM
International Headquarters
7, rue d'Aumale - 75009 - Paris - France
Email: admission@chaine-des-rotisseurs.net
Tel: +33 1 42 81 30 12 Fax: +33 1 40 16 81 85
PROFESSIONAL MEMBER
Page 3 of 3
SPONSORSHIP*
Sponsors:
1.
2.
Last Name
First Name
Grade
National Bailliage
Last Name
First Name
Grade
National Bailliage
First Name
National Bailliage
Signature Code
Communicated by the International
Headquarters
Date
Day
Month
Year
Credit Card
Cash
Expiry
Cheque
Bank Transfer
Currency
Amount
Card N
Month
Year
Security Code
OTHER INFORMATION/
COMMENTS