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1 Membership form Our company wants to join the Agri-Food Export Group and the many benefits of its membership. We believe that we meet to the only admission requirement which is to have a keen interest for exporting Quebec agri-food products. Our only obligation hereby is to pay $375,00 (plus GST and QST )= total $431,16 covering our membership fee for the rest of ) Company official name French name : English name : 2) Complete address City and Province Postal code 3) Year founded: Number of employees: 4) Phone. : Phone : Fax: Internet: Information in the following section will be used to invite you to participate in activities such as trade fairs, training, etc. or to invite you to submit your requests on financial export programs. Please pay attention on addresses. 5) Key executive Mr. Ms Name Export contact Nane: Third contact (optional) Name : Logistic and customs contact Name: Quality insurance contact Name: R & D and/or marketing coordinator Name: 6) Type of firm manufacturer OR other (check only 1 category) advertising and promotion agency financial institution mercantile agent translator broker Insurance broker producer travel agency carrier int l trading house producer s association university organization consultant legal counsel research center and laboratory Wholesaler marketing service trade association distributor manufacturer s agent customs broker and international technical adviser economic development freight forwarder organization 1 / 2

2 The information contained in the next two issues will be a reference to the search engine on the Export Group s website. To maximize the benefits of your membership, make sure to give us a good description of your products (question #7) and business (question #8). 7) Products or services available for export (please complete this information in French and English) English : French : 8) Additional information about your company (in a text of about 100 words, please describe your company or what differentiates you from the competition use an extra page if necessary) English: French: 9) Total annual sales under $ to 1 million $ 1 to 5 millions $ 5 to 10 millions $ 10 to 25 millions $ 25 to 50 millions $ 50 millions $ and over Export under $ to 1 million $ 1 to 5 millions $ 5 to 10 millions $ 10 à 25 millions $ 25 to 50 millions $ 50 millions $ and over 10) Current export markets (countries where you export) Target markets (where you are interested to export) 11) Clientele (check where appropriate) Agents distributors associations exporters trading houses producers supermarkets hotels wholesalers retailers importers institutions restaurants manufacturers 12) Type of commercial opportunities desired (check where appropriate) retailers breeders associations wholesalers distributors institutions government agencies supermarkets manufacturers manufacturers (sublicense, joint venture) agents or trading houses technological brokers 13) Respondent who completed this questionnaire Mr. Mrs Name : Signature : Date: 1971, Léonard-De Vinci Sainte-Julie, Quebec Canada J3E 1Y9 T (450) F (450) info@groupexport.ca g r o u p e x p o r t. c a 2 / 2

3 CATÉGORIES DE PRODUITS Alcools, bières, cidres, hydromels, moûts, vins et autres liqueurs et spiritueux Aliments pour animaux, conditionnés pour la vente au détail Aliments pour bébés Animaux vivants et génétique animale Boissons énergétiques, non alcoolisées Cafés, thés et tisanes Céréales, farines, gruaux, semoules, fécules et pâtes alimentaires Collations, grignotines Confitures, marmelades, gelées, tartinades, purées, pâtes de fruits Eaux, eaux minérales ou eaux gazéifiées Eaux, eaux minérales, eaux gazéifiées, additionnées de sucre, édulcorants ou aromatisées Emballages industriels, équipements, technologies Épices, assaisonnements, ingrédients et additifs Fruits frais, surgelés, en conserve ou séchés Huiles végétales et oléagineux Jus et boissons de fruits ou de légumes Légumes frais, surgelés, en conserves ou séchés Mets préparés, hors d œuvres et épicerie fine Noix, amandes, noisettes, pistaches, arachides et graines Poissons et fruits de mer - frais, congelés ou transformés Produits d origine animale : graisses, boyaux, peaux, cuirs, fourrures Produits de boulangerie, de pâtisserie et autres desserts Produits de l érable Produits diététiques, naturels et suppléments alimentaires Produits laitiers et œufs Semences, engrais, plantes vivantes et produits de la floriculture Soupes, sauces, marinades et condiments Soya et produits à base de soya Sucre, confiserie, chocolat et miel Viandes bovines - fraîches, congelées ou Viandes chevalines, ovines ou caprines - fraîches, congelées ou Viandes de canards, d oies, cailles ou pintades - fraîches, surgelées ou Viandes de gibier - fraîches, congelées ou Viandes de volailles (poulets, dindons) - fraîches, surgelées ou Viandes porcines - fraîches, congelées ou (incluant les charcuteries) PRODUCT CATEGORIES Alcohols, beers, ciders, mead, musts, wines, liqueurs and spirits Animal feed, processed for retail market Baby food Livestock and animal genetics Energy drink (non-alcoholic) Coffee, tea and herbal tea Cereals, flour, oatmeal, semolina, starch and pasta Snack food Jam, jellies, marmalades, spreads, fruit puree or fruit paste Water, mineral water or sparkling water Water, mineral water, sparkling water, with sugar, sweetener or flavor added Industrial packaging, equipment, technologies Spices, seasonings, ingredients and food additives Fruits, fresh - frozen, canned or dried Vegetable oils and oilseed Fruit or vegetable juices and drinks Vegetables - fresh, frozen, canned or dried Prepared meals, hors d œuvres and fine food Nuts, almonds, hazelnuts, pistachios, peanuts and seeds Fish and seafood - fresh, frozen or processed Animal by-products : fat, guts, skin, leather and fur Bakery and pastry products, and other desserts Maple products Health food, natural and nutritional supplements Dairy products and eggs Seeds, fertilizer, plants and floriculture products Soups, sauces, marinades and condiments Soybean and soybean products Sugar, confectionery, chocolate and honey Beef meat - fresh, frozen or processed Horse, sheep or goats meat - fresh, frozen or processed Duck, goose, quail or guinea fowl meat - fresh, frozen or processed Game meat - fresh, frozen or processed Poultry meat (chicken, turckey) - fresh, frozen or processed Pork meat - fresh, frozen or processed (including cooked pork meat) VOIR VERSO POUR CATÉGORIES DE SERVICES ET»»

4 CATÉGORIES DE SERVICES Analyses chimiques et nutritionnelles Associations professionnelles et commerciales Banques, assurances, financement et conseils juridiques Equipement, mécanique de bâtiment et matériel pour assainissement Graphistes, photographes, imprimeurs Maisons d édition spécialisées en agroalimentaire Maisons de commerce Marketing et communication Recherche et développement Services de certification Services professionnels, techniques et commerciaux Solutions informatiques Kiosques vente, location et supervision technique Transport, dédouanement, assurances et entreposage Biologique CAC (Contrôle allergène certifié) Cacher Canada GAP (bonnes pratiques agricoles) GFSI-BRC SERVICE CATEGORIES Chemical and nutritional analysis Business and professional associations Bank, insurance, financing and legal counsel Equipment, building systems, sanitizing products Graphic designer, photograph, printer Food editors and publishing groups Trading house Marketing and communication Research and development Certification services Professional, technical and commercial services Data processing solutions Stands sales, rental and technical supervision Transport, custom clearance, insurance and warehousing Organic CAC (Certified allergen control) Kosher Canada GAP (Good Agricultural Practices) CFSI-BRC GFSI-FSSC GFSI-FSSC ISO ISO SMC Produits équitables Sans gluten Sans OGM MSC Fair trade products Gluten free GMO free

5 CATÉGORIES DE PRODUITS Alcools, bières, cidres, hydromels, moûts, vins et autres liqueurs et spiritueux Aliments pour animaux, conditionnés pour la vente au détail Aliments pour bébés Animaux vivants et génétique animale Boissons énergétiques, non alcoolisées Cafés, thés et tisanes Céréales, farines, gruaux, semoules, fécules et pâtes alimentaires Collations, grignotines Confitures, marmelades, gelées, tartinades, purées, pâtes de fruits Eaux, eaux minérales ou eaux gazéifiées Eaux, eaux minérales, eaux gazéifiées, additionnées de sucre, édulcorants ou aromatisées Emballages industriels, équipements, technologies Épices, assaisonnements, ingrédients et additifs Fruits frais, surgelés, en conserve ou séchés Huiles végétales et oléagineux Jus et boissons de fruits ou de légumes Légumes frais, surgelés, en conserves ou séchés Mets préparés, hors d œuvres et épicerie fine Noix, amandes, noisettes, pistaches, arachides et graines Poissons et fruits de mer - frais, congelés ou transformés Produits d origine animale : graisses, boyaux, peaux, cuirs, fourrures Produits de boulangerie, de pâtisserie et autres desserts Produits de l érable Produits diététiques, naturels et suppléments alimentaires Produits laitiers et œufs Semences, engrais, plantes vivantes et produits de la floriculture Sirops pour cocktails (non alcoolisés) Soupes, sauces, marinades et condiments Soya et produits à base de soya Sucre, confiserie, chocolat et miel Viandes bovines - fraîches, congelées ou Viandes chevalines, ovines ou caprines - fraîches, congelées ou Viandes de canards, d oies, cailles ou pintades - fraîches, surgelées ou Viandes de gibier - fraîches, congelées ou Viandes de volailles (poulets, dindons) - fraîches, surgelées ou Viandes porcines - fraîches, congelées ou (incluant les charcuteries) PRODUCT CATEGORIES Alcohols, beers, ciders, mead, musts, wines, liqueurs and spirits Animal feed, processed for retail market Baby food Livestock and animal genetics Energy drink (non-alcoholic) Coffee, tea and herbal tea Cereals, flour, oatmeal, semolina, starch and pasta Snack food Jam, jellies, marmalades, spreads, fruit puree or fruit paste Water, mineral water or sparkling water Water, mineral water, sparkling water, with sugar, sweetener or flavor added Industrial packaging, equipment, technologies Spices, seasonings, ingredients and food additives Fruits, fresh - frozen, canned or dried Vegetable oils and oilseed Fruit or vegetable juices and drinks Vegetables - fresh, frozen, canned or dried Prepared meals, hors d œuvres and fine food Nuts, almonds, hazelnuts, pistachios, peanuts and seeds Fish and seafood - fresh, frozen or processed Animal by-products : fat, guts, skin, leather and fur Bakery and pastry products, and other desserts Maple products Health food, natural and nutritional supplements Dairy products and eggs Seeds, fertilizer, plants and floriculture products Cocktail syrups (non-alcoholic) Soups, sauces, marinades and condiments Soybean and soybean products Sugar, confectionery, chocolate and honey Beef meat - fresh, frozen or processed Horse, sheep or goats meat - fresh, frozen or processed Duck, goose, quail or guinea fowl meat - fresh, frozen or processed Game meat - fresh, frozen or processed Poultry meat (chicken, turckey) - fresh, frozen or processed Pork meat - fresh, frozen or processed (including cooked pork meat) VOIR PAGE SUIVANTE POUR CATÉGORIES DE SERVICES ET»»

6 CATÉGORIES DE SERVICES Agence de branding et de design Analyses chimiques et nutritionnelles Associations professionnelles et commerciales Banques, assurances, financement et conseils juridiques Equipement pour assainissement, programme d hygiène & salubrité Graphistes, photographes, imprimeurs Maisons d édition spécialisées en agroalimentaire Maisons de commerce Marketing et communication Recherche et développement Services de certification Services professionnels, techniques et commerciaux Solutions informatiques Kiosques vente, location et supervision technique Transport, dédouanement, assurances et entreposage Biologique CAC (Contrôle allergène certifié) Cacher Canada GAP (bonnes pratiques agricoles) GFSI-BRC SERVICE CATEGORIES Branding and design agency Chemical and nutritional analysis Business and professional associations Bank, insurance, financing and legal counsel Equipment and sanitizing products, hygiene and safety program Graphic designer, photograph, printer Food editors and publishing groups Trading house Marketing and communication Research and development Certification services Professional, technical and commercial services Data processing solutions Stands sales, rental and technical supervision Transport, custom clearance, insurance and warehousing Organic CAC (Certified allergen control) Kosher Canada GAP (Good Agricultural Practices) CFSI-BRC GFSI-FSSC GFSI-FSSC ISO ISO SMC Produits équitables Sans gluten Sans OGM MSC Fair trade products Gluten free GMO free SQF SQF niveau 2 SQF niveau 3 SQF SQF Level 2 SQF Level 3 Autre : Autre : Other: Other:

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