Associate Member Application (Pay with Check)

To join, complete this application & return with payment for first year’s dues to:

KENTUCKY RESTAURANT ASSOCIATION
133 EVERGREEN ROAD, SUITE 201 LOUISVILLE, KY 40243
502-400-3736
502-896-0465 FAX
[email protected]

Payment Details
This information is required
ASSOCIATE MEMBER APPLICATION DUES*
Price:
Subsidiaries
- Check here if you have subsidiaries to your parent company that you would like to add. We will contact you for the information. Each additional listing is $65.00.
Subsidiaries*
Price:
Business Name
Contact Name*
First Last
Title*
Website
Email*
Phone*
Primary Address*
Street Address Address Line 2 City State ZIP Code
Hours of Operation Per Day*
Category*
Description Of Your Business To Be Used On The Website*
Membership Status*
- New Member
- Renewal
Billing Details
This information is required
To the Board of Directors: I submit my application for membership in the Kentucky Restaurant Association.
Signature*
Date*
MM slash DD slash YYYY
Total
$0.00
CAPTCHA

Payment Details