Educational Membership (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

Payment Details
This information is required
Educational Membership Dues*
Price:
School Name*
Contact Name*
First Last
Title*
Website
Email*
Phone*
Address*
Street Address Address Line 2 City State ZIP Code
Hours of Operation*
Membership Status*
- New Member
- Renewal
Billing Details
This information is required
I submit my application for membership in the Kentucky Restaurant Association.
Signature*
Date*
MM slash DD slash YYYY
CAPTCHA