Membership Application
RUSSELL
Phone 270-866-4333 Fax 270-866-4304
www.russellcountyky.com Email:
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BUSINESS:
TELEPHONE:_____________________________
EMAIL: __________________________________
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MEMBERSHIP INVESTMENT SCHEDULE |
INDIVIDUAL $ 50.00
PROFESSIONAL $ 85.00
SPONSORSHIP $300.00 Minimum
FINANCIAL INSTITUTION $ 10.00 per million ($500.00 max)
BUSINESS PER SCHEDULE
INDUSTRIAL PER SCHEDULE
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# OF EMPLOYEES INVESTMENT AMOUNT |
1---5 $ 85.00
6--10 $110.00
11-20 $140.00
21--50 $200.00
51--100 $250.00
101-200 $375.00
Over 200 $500.00
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CATEGORY/BUSINESS CLASSIFICATION |
___AUTOMOTIVE ___INSURANCE ___RESTAURANT
___BROADCASTING ___MANUFACTURER ___RETAIL
___CONSTRUCTION ___MEDICAL ___SERVICE
___FINANCIAL ___NON-PROFIT ___SPONSORSHIP
___HOTEL/MOTEL/APTS ___PROFESSIONAL ___TRANSPORTATION
___INDIVIDUAL ___PUBLISHER/PRINTER ___UTILITIES
___INDUSTRIAL ___REAL ESTATE ___OTHER
Signature: ________________________________ Date: _________________
