URA MEMBER APPLICATION Restaurant / Company InformationRestaurant / Company Name(Required)Website Contact First Name(Required)Contact Last Name(Required)Contact Phone Number(Required)Contact Email(Required) Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Restaurant DetailsChef's NameChef's Email Food & Beverage Director's NameFood & Beverage Director's Email Primary CuisineType of RestaurantAmenities Banquet Facilites Liquor License Select AllMembership DuesGross Annual Revenue$1 to $100,000$100,001 to $250,000$250,001 to $500,000$500,001 to $750,000$750,001 to $1,000,000$1,000,001 to $2,000,000$2,000,001 to $3,000,000$3,000,001 to $4,000,000Renewal Renewal Total hCaptcha Secure Credit Card Card Holder* Card Number* Card Expiration* Card CVV* CommentsThis field is for validation purposes and should be left unchanged. Δ
