Date____/____/______
Referred by ___________________________________________
Name ________________________________________________
Title _________________________________________________
Business or Organization _________________________________
Address_______________________________________________
City____________________________ State______ Zip ________
Phone ______________________ Fax ______________________
E-mail________________________________________________
Web Site ______________________________________________

Please enroll me under the following category:
( ) $50 - Student, County Extension Agent or Individual (Circle category that applies)
( ) $75 - Retail Business with three or fewer employees
( ) $110 - Additional voting member for any current member organization
( ) $135 - Individual Membership for Tourism Matching Funds Regional Committee
( ) $165 - Attractions, campgrounds, festivals, fairs & events, local government agencies, lodging facilities (50 rooms or less), marinas (50 slips or less), restaurants (50 seats or less) (Circle category that best applies)
( ) $220 - Area development districts, car rental agencies, chambers of commerce, educational institutions, tour operators, travel agencies, lodging facilities (51 rooms or more), marinas (51 slips or more), restaurants (51 seats or more) (Circle category that best applies)
( ) $330 - Industry suppliers/corporate supporters
( ) $440 - Convention centers or state government agencies (Circle category that best applies)

* Annual dues for tourist commissions and convention & visitors bureaus are based on annual budget.

For more information, call (502) 223-8687.

A check for $_________ payable to the Kentucky Tourism Council is enclosed.
Please charge my membership to ( ) Visa ( ) Mastercard
Account #__________________________ Exp. date____________
Authorized Signature _____________________________________

Return by mail to:
Kentucky Tourism Council
1100 US 127 South, Bldg. C
Frankfort, Kentucky 40601
Or fax to (502) 223-5646

Kentucky Tourism Council
1100 127 South, Building C
Frankfort , KY 40601

Phone: 502 223-8687
Fax: 502 223-5646
Email: ktc@mis.net

© Kentucky Tourism Council, 2002

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