上 海 钻 石 交 易 所

上海钻石交易所会员申请表

Shanghai Diamond Exchange

Membership Application Form

(Please also complete the Corporate Details)

公司名称（中英对照）

Name of Company (in Chinese & English)

公司注册(请附复印件) Business Registration No. （Please attach copy）地址和邮政编码

Address and Post Code：

电话传真电子邮箱

Tel：Fax：E-mail：

经营钻石或珠宝首饰业务年限

Years of affiliation in diamond or jewelry business

开户银行

Banks of Account

两名推荐会员的名称（请附推荐书）：

Names of Two Recommending Members (Please attach Recommendation)

其他相关会籍

Membership of other related organizations

I, the undersigned, duly authorized by the above company, hereby apply to be the representative of the Corporate Member of Shanghai Diamond Exchange, China and in the event of being accepted, I agree to be bound by and abide by the regulation of the Exchange. 本人为下列签署人，并获上述公司授权，现申请为上海钻石交易所会员代表，如被接纳，愿遵守会章。

I confirm that the particulars specified above are correct. 本人确认上述资料正确The information reauested is to be used for membership application only and will be

treated confidentially. The information will be passed to the Shanghai Diamond Exchange Council for assessment purpose. 本人同意此表只做会员申请用途资料，并供上海钻石交易所理事会作批核用途。本人所提供资料将予以保密。

日期申请人签名（并加盖公司图章）

Date：Applicant’s signature ( with company chop)

法人代表姓名中文

Name of legal representative：Chinese

职位出生日期

Position：Date & place of Birth：

国籍

Nationality:

身份证或护照编号(请附副本)

ID or Passport No：（Please attach copy）地址

Residential address：

电话

Tel：

备注：(1)入会申请一旦被接受，会员应于一周内将有关费用划入上海钻石交易所指定的帐户。

If application accepted, the Member should pay the relevant fees to the account designated by the Exchange within on week.

(2)有关费用的规定，请参考入会简章。

For required fees, please refer to the Membership Information

填妥此表后，请回寄上海钻石交易所会员部

Please return the form to Membership Affairs of Shanghai Diamond Exchange

地址：中国上海浦东新区世纪大道1701号中国钻石交易中心1507室

Add: Rm 1507 China Diamond Exchange Center, No. 1701 Century Boulevard, Pu Dong New Area, Shanghai, China 200120

联系人：傅宗琦

Contact: Cooper Fu

电话：86-21-50158197

Tel: 86-21-50158197

传真：86-21-50158094

Fax: 86-21-50158094

电子信箱：cooper@

E-mail: cooper@

上海钻石交易所

SHANGHAI DIAMOND EXCHANGE CO.,LTD.

CORPORATION DETAILS 公司资料

General information 公司资料

1、Name of Company 公司名称：

2、Head Office Address 公司总部地址：

3、Tel. No.电话：Fax. No.传真：

4、E-mail address 电子邮件地址：

5、Branch office address 分公司地址：□See attached

(For multiple branches, please attach a list of branches separately 如超过一家分公司另外填写)

6、Related interest 附属公司：□See attached

(For multiple branches, please attach a list of branches separately 如超过一家分公司另外填写)

7、Date of Establishment 公司成立日期：

8、Business Registration No. 工商登记证号码：

9、Registered Capital 注册资本：

10、Type of Ownership 公司性质：

□State-owned Company 国有企业

□Private Company 私营企业

□JV Company 中外合资公司

□Sole Proprietorship 外商独资企业

□Listed Company 上市公司

□Share-holding Company 股份公司