Region 3 Chamber of Commerce and Industry

R3CCI Crowdfunded Community Company

Bio Form

Required for all participants in accordance with the Laws of Guyana

📋Personal Details

Full Legal Name (as on ID) *

Date of Birth *

Gender *

MaleFemaleOther

Nationality *

National ID or Passport Number *

📞Contact Details

Mobile Number *WhatsApp preferred

Email Address *

Home Address *Village/Town & Region

💰Participation Details

How much do you wish to contribute? *

Source of Funds *

EmploymentBusiness IncomeSavingsOther

✅Declaration

I declare that the information provided above is true and correct. I understand that my participation in the community company is voluntary, and subject to vetting under Guyana's AML/CFT laws.

I agree to comply with all relevant rules of the R3CCI Crowdfunded Company.

I accept the declaration above *

Digital Signature *

By typing your name, you are providing a legal signature

Confidentiality Notice

All information submitted will be kept confidential and used solely for legal compliance and management of the R3CCI Crowdfunded Community Company.