Company Name(Required)A Craft Supporter is considered a partner in good standing by abiding by all applicable federal, state, and local laws and ordinances; abiding by the Code of Responsible Practices; and by paying such dues that are assessed annually. A Craft Supporter is considered a partner in good standing by abiding by all applicable federal, state, and local laws and ordinances; abiding by the Code of Responsible Practices; and by paying such dues that are assessed annually.By(Required) First Last Title Date(Required) MM slash DD slash YYYY Company ProfileAddress(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone(Required)FaxWebsite(Required) How do you want your distillery to appear for public purposes?(Required)Name and contact information of principal corporate officer: Name(Required) First Last Title(Required)Email(Required) Mobile(Required)Is applicant incorporated in the U.S?(Required) Yes No If so, in what state?(Required)Signature(Required) First Last Contribution Levels Stripped sales under $5,000,000: $100 Stripped sales more than $5,000,000 and less than $10,000,000: $300 Stripped sales more than $10,000,000 and less than $30,000,000: $1,000 (Custom amount to contribute-minimum $100) This will be reviewed and approved by the Responsibility.org membership department.Name *Contributions made after July 1st of the calendar year will be pro-rated at 50% and Craft Supporter affiliations are done on a calendar year basis.Additional EmployeesName Name and contact information for additional employees who should receive electronic correspondence from Responsibility.org (i.e. newsletters, legislative reports, webinar invites, responsibility tips, messaging, resources)Name First Last Email TitlePhoneName First Last Email TitlePhoneName First Last Email TitlePhoneName First Last Email TitlePhone
