LICA Membership Application Form

Fields marked with an * are required

for new and renewing members

1. Contact information

Company/Organization representative

Secondary Contact

Website & Social Media


100% Lao investment
Joint Venture
Wholly Foreign Owned

2. Business information


Describe your organisation (Tell us as much as possible to let us know more about your organization): 0 of 500 Character(s) left






3. Membership & Sponsorship fees


Gold Sponsor: 25,000,000 Kip / Year
Silver Sponsor: 10,000,000 Kip / Year
Bronze Sponsor: 5,000,000 Kip / Year

Ordinary Membership: 2,000,000 Kip / Year
Affiliate Membership: 1,500,000 Kip / Year
Individual Membership: 300,000 Kip / Year

4. Method of Payment

Pay by bank transfer, cash or cheque directly into the following bank account.

Bank Name: RHB Bank Lao Limited Bank Address: No. 01, House No. 008, Kaysone Phomvihane Rd., Phonxai Village, Vientiane Capital, Lao PDR Account No.: 100 000 100 000 2610 (LAK) Swift Code: RHBBLALA

Note: Please add your Organisation’s name (or your name) in the transaction particulars. This is the only unique identifier that will verify you have paid your membership

For further information email:

1.) Mr. Keovisouk Dalasane (Vice President)

Contact Number or WahtsApp: +856 20 5588 5011 Email: keo@108.jobs

2.) Mr. Khamkhoun Phimmasone (Secretary General, and Finance)

Contact Number or WhatsApp: +856 20 7787 Email: Khamkhoun.pms@gmail.com

5. Documents to be submitted along with Membership Application Form.

*

  1. A copy of the Enterprise Registration Certificate
  2. A copy of the Business Licence, if applied
  3. A copy of ID card or Passport Number (for foreigners) (showing ID or Passport Number and Expiration Date)
  4. A copy of Tax Registration Licence (or most recent Tax payment certificate)
  5. Representative of your company or the photo of individual membership