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Kentucky Fried Chicken Application

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                        MEMBERSHIP APPLICATION
         NORTHWEST KENTUCKY FRIED CHICKEN FRANCHISEE ASSOCIATION




Name__________________________________________Spouse_______________________

Company____________________________________________________________________

Address_____________________________________City_________ ___________________

State______Zip______________Email____________________________________________

Office Phone_______________ ___________________Fax____________________________

Areas of Operation in the Northwest Region (Washington, Oregon, Idaho, Alaska,
Wyoming, Montana, Nevada, California, Colorado)

       City and State                                     City and State

______________ __________________          ______________ ____________ ___________

______________ __________________          ______________ ____________ ___________

______________ __________________          ______________ ____________ ___________

________________________________           ______________ ____________ ___________
(Use back if needed…or you may attach a preprinted list.)


Dues Structure:                            Total Number of KFC Restaurants_______

First Store     $225
2-5th Stores    $50 each                   Computed Dues $____________
6-25th Stores   $35 each
26th and up     $15 each                   ______________ ____________ ________
                                           Franchisee Signature
                                                  Date_______________________

Please send completed Application and check to:

       Northwest KFC Franchisee Association
       P O Box 1057
       Bouse, AZ 85325
       E-Mail: patw4nwkfc@aol.com

				
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