Associate Member Application Payment DetailsThis information is requiredASSOCIATE 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 AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Hours of Operation Per Day* Category*Select one that best describes your businessAccounting / FinancialAdvertisingAdvertising / Promotions AssociationAdvertising/Public Relations/PromotionApparel/Promotional ItemsAudio Visual EquipmentAutomated Teller Machines (ATMs)Bakery ProductsBeef Industry PromotionBeerBeverages (Alcoholic) Cash Registers / Supplies Chemical / Clean SuppliesBusiness Software ManagementBusiness TechnologyCleaning ServicesCO2Coffee, Tea, Hot ChocolateCommercial Kitchen Space ( To Share )Commercial LandscapingComputers / SuppliesConstruction / Design ConsultantsConstruction/Restaurant DesignConsultantsConsultants - Cost ReductionConsultants - Foodservice Consultants- Menu / Nutrit.Convention & Visitors Bur.Cooking FuelCredit Card ProcessingCPR TrainingDairy ProductsDeli ProductsDessertsDirect Service DeliveryDishwashing EquipmentDistilleriesDrug TestingElectrical/LightingEntertainment VenueEvents/FestivalsExhaust System CleaningExterior Pressure WashingFacilities MaintenanceFire & Safety ServicesFire & Water Cleanup/RestorationFire Suppression/ExtinguishersFlour/CornmealFood BankFood BrokersFood DeliveryFood ManufacturerFoodservice DistributorsFoodservice Equipment DistributorFranchise DevelopmentFrozen FoodsFruits and VegetableFryer Management ServiceGamingGift Cards - ElectronicGourmet FoodsGrease RemovalGrease Trap ServiceGroup PurchasingHood CleaningHood Filter Sales & ServiceHospitality Profit SolutionsHVACHVAC CleaningIce CreamIce Machines / DispensersImmunization and Vaccination Solution ProgramInstitutional Foods InsuranceInsuranceInsurance - Property & CasualtyKentucky ProductsLED LightingLegal ServicesLinensMarketingMeatsMobile RefrigerationMunicipalityMusic/Music LicensingMystery ShoppingOil MicroFiltrationPaper ProductsPavement / Parking LotsPayroll ProcessingPest ControlPhysician - CarePies & CakePizza SuppliesPlumbingPoint of Sales EquipmentPoultryPressure Washer SalesPrintingProducePublicationsReal Estate / AgentRecruitersRecyclingRepairs & MaintenanceResidual Decontamination w/o ReapplicationRestaurant Equipment Parts & ServiceRestaurantsSanitizing/DecontaminationSeafoodSecurity / Alarm SystemsStaffingSoft DrinksTax ComplianceTechnologyTechnology - Copiers/PrintersTechnology App - Developer NetworkTechnology App - Guest ManagementTelecommunicationsTelevisionText Message MarketingTourismTrainingTransportation/Taxi ServiceUniformsUtility ServicesViral Marketing - (Email, Internet, Online Video) Exhaust System CleaningWaste Grease EliminationWaste Removal ServicesWine Doggy BagsWine/Spirits WholesalersWineryWorkforce DevelopmentDescription Of Your Business To Be Used On The Website*Membership Status* New Member Renewal Billing DetailsThis information is requiredTo the Board of Directors: I submit my application for membership in the Kentucky Restaurant Association.Signature*Date* MM slash DD slash YYYY Billing Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Secure Credit Card Card Holder* Card Number* Card Expiration* Card CVV* Total $0.00 CAPTCHA