Membership Application
APPLICATION & DUES ARE DUE ON JANUARY 1, 2009 GENERAL MEMBERSHIP Please Type or Print ASSOCIATE MEMBERSHIP Mr. ________ Mrs. ________ Ms.: ____________________ __________________________________ FIRST NAME
GENERAL MEMBERSHIP ANNUAL DUES 1 STORE $ 350.00 2-4 STORES $ 450.00 5 OR MORE $ 600.00
__________________________________ LAST NAME (FAMILY NAME)
________________________________________________ CORPORATE NAME ________________________________________________ MAILING ADDRESS ________________________________ ________________ CITY STATE ZIP CODE ________________________________ E-MAIL ________________________________ FAX ________________________________ VOICE MAIL NODE / BOX NUMBER ________________________________ NAME OF SPOUSE
SPODS=1/2 STORE ASSOCIATE MEMBERS $350.00
____________________________________ BUSINESS PHONE ____________________________________ DIVISION REGION
_____________________________________ APPROVED OPERATOR (CHECK IF YES)
NAME OF OTHER APPROVED OWNER OPERATORS IN YOUR ORGANIZATION WITH LESS THAN 51% OF ANY RESTAURANT OWNERSHIP. __________________________________ # OF FREE STANDING RESTAURANTS ________________________________ NAME ________________________________ NAME ________________________________ NAME MAKE CHECKS PAYABLE TO: MHOA SEND PAYMENT TO: _____________________________________ NUMBER OF SPODS ______________________________________ RELATIONSHIP VOICE MAIL NODE/ BOX ______________________________________ RELATIONSHIP VOICE MAIL NODE/ BOX _______________________________________ RELATIONSHIP VOICE MAIL NODE/ BOX Please Fill out Application out completely to ensure we have all your information updated in our files. Thank you for your cooperation.
MHOA c/o Alex Mestas, Treasurer 26605 Kelvin Court, Suite A Murrieta, CA 92562