Membership 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
Dues Schedule*
Membership dues are based on your annual food & beverage revenue in Kentucky. (Multi-unit firms use combined gross sales for KY units)
Restaurant*
Additional Locations
- Check here if there are additional locations to be added in this membership. We will contact you for that information.
Contact Name*
First Last
Title*
Website
Email*
Phone*
Address*
Street Address Address Line 2 City State ZIP Code
Is This Location The Corporate Office?*
- Yes
- No
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
Total
$0.00
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Payment Details