NCSLA Associate Membership Application

 

Business Name: Application is hereby made for associate membership in the National Conference of State Liquor Administrators, in the following category (check one):
    Supplier-small (1-9 brands)
    Supplier-large (10 or more brands)
    Wholesaler-small (single state)
    Wholesaler-large (multi-state)
    Retailer-small (single state)
    Retailer-large (multi-state)
    Trade Association-small (single state)
    Trade Association-large (multi-state)
    Law Firm-small (individual Bev. Alc. practice)
    Law Firm-large (multi-person Bev. Alc. practice)
    Other (consultants, industry-related businesses, etc.)
Trade Name:
Address:
City State & Zip:
Phone:
Fax:
Web Address:
Contact Person:
Title:
Email:
Alt. Contact Person:
Alternate Email:
 
The undersigned, representing the applicant, agrees to uphold the standards and integrity of the National Conference of State Liquor Administrators, abide by the organization's constitution and bylaws as may be applicable, and agrees, to the extent possible, to actively attend meetings and conferences of the association.
Signature:
Date:
 
After applicant remits applicable membership fee (as advised by Executive Director), applicant automatically becomes an associate member, entitled to all privIleges of an associate member, subject to a confirmation vote at the next annual conference. Membership year is July 1 through June 30.
YOU MUST BE A BONAFIDE MEMBER OR ASSOCIATE MEMBER TO ATTEND ANY NCSLA MEETING OR EVENT.