Membership Application

 
   
Organization Information (to be displayed online)
Restaurant Name *
Corporate Name *
Contact Person
First Name *
Last Name *
Title
Address 1 *
Address 2
City *
State *
Zip *
Office Phone *
Fax
Cell Phone
Email
(vital for e-newsletters, legislative alerts, etc.) *
Website
Liquor License *
Beer/Wine License *
Industry Segment *
Establishment Type *
Annual Dues Investment
Annual Dollar Volume: *

(Based on Annual Food & Beverage Dollar Volume for All Minnesota Units)

Total: $ 
Select your Membership Representative *
Dues investments are not tax deductible as charitable contributions for income tax purposes, but may be tax deductible as ordinary and necessary business expenses subject to restrictions imposed as a result of association lobbying activities. The estimated non-deductible portion of your dues allocable to lobbying is 36%.

The contents of this box are for testing purposes. This box will be removed when the form goes live.
Full-Time Employees
Part-Time Employees
Hotel/Motel Rooms
Restaurant Seats
Additional Associates
Additional Associates Cost
Additional Locations
Additional Locations Cost
Assets
Assets Cost
AdditionalCategories
Additional Categories Cost
NumberOfAdditionalCategories
additionalItem1Cost
Annual Dues (charged to card)
Tax (charged to card)
Fee (charged to card)
tempValueForDropDown1
Number of Full Time Employees:  
Number of Part Time Employees:  
Number of Rooms (Accommodations):  
Number of Seats (Restaurants):  
Number of Associates (Realtors, Attorneys):  
Number of Locations ($35/add. location):  
Millions in Assets (Financial Institutions):  
Enhanced Membership ($50):
   
$ 
$ 
$ 
*
NOTE: If selecting to pay by Check, please do not fill out the Credit Card Information section at the bottom of the form. Thanks.
Primary Directory Category *
Additional Directory Categories
  • Primary Directory listing is complimentary
  • Up to two additional Directory listings are complimentary
  • After two, additional Directory listings are $35 each
**Hold CTRL on your keyboard to select multiple categories**
Credit Card Information
Credit Card Type *
Credit Card Number * 
Name On Card
Security Code
Valid Through
Credit Card Address 1
Credit Card City
Credit Card State
Credit Card Zip
Credit Card Phone Number
Credit Card Email Address
Please click submit only one time.  The transaction may take several seconds.

Minnesota Restaurant Association