Company Name: __________________________________________  Year Established: ________

Company Website: _________________________________________  No. of Employees: _______

Address:_________________________________________________

City:________________________________  State:_______________ 

Zip:______________

Phone Number: _____________________________

Fax Number:________________________________

Email: ______________________________________

Please provide three references from your customers:

Reference #1. Name: __________________  Company Name: ___________________________

Company Website: ______________________________  Phone Number: __________________

Email: __________________________

Reference #2. Name: __________________  Company Name:___________________________

Company Website: ______________________________  Phone Number: __________________

Email: __________________________

Reference #3. Name: __________________  Company Name: ___________________________

Company Website: ______________________________  Phone Number: __________________

Email: __________________________

Signature: ___________________________  Date: ______________________

Please mail the form to

American China Manufacturers & Exporters Association
401 N. Garfield Ave. #1
Alhambra CA 91801, USA

or Fax it to

(626) 282-9252