SWCCI Nominated Representative Form - South West Chamber of Commerce and Industry Inc.

Please complete this form to confirm your Chamber's membership with the SWCCI.

Nominate up to four (4) representatives for your CCI. Please note: If more than one (1) representative of any CCI sits on the Executive Committee, the member (your CCI) is entitled to only one vote as per the constitution.
Name of your CCI*
Email*
Phone*
Website*
Nominee 1*
First Last
Current CCI Role of Nominee 1*
Nominee 2
First Last
Current CCI Role of Nominee 2
Nominee 3
First Last
Current CCI Role of Nominee 3
Nominee 4
First Last
Current CCI Role of Nominee 4
Name
This field is for validation purposes and should be left unchanged.