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KICVB Membership Application


Membership is renewed automatically on the anniversary of your enrollment. Membership benefits will continue in effect until such time as KICVB received written notice to discontinue membership or dues are past due.

Business Name :
Owners:
Voting Member:
Physical Address:
Mailing Address
(if different from above):
Billing Address
(if different from above):
Business Phone:
Toll-Free #:
Fax Number:
E-Mail Address:
Home Page/Website:

Business Category:
Select one of the following categories that best describes your primary business:


Use the control key to select more than one category. To list your business under the same name in different categories, there is an additional annual fee of $10 per category (does not include Visitor's Guide).

Signature:
Title:
Date:

Membership Category
Annual Investment Schedule
Number of Full Time Employees and/or Equivalent Part Time Employees (Including Self in Self-Employed):
Choose a level of membership:
  (**Not eligible for business benefits, to vote or hold office.)
   
 

 

 


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