Membership Application | Connecticut Restaurant Association | Wethersfield, CT

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Legislative Session 2025

Membership Application

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Business Information (to be displayed online)

Business Name/DBA Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Corporate Name Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Address 1 Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Address 2 Required Please enter a valid number Please enter a valid date Please enter valid credit card information

City Required Please enter a valid number Please enter a valid date Please enter valid credit card information

State

Zip Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Phone Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Fax Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Website Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Email Required Please enter a valid number Please enter a valid date Please enter valid credit card information Must be a valid email address

Contact Person

First Name Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Last Name Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Title Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Phone Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Email Required Please enter a valid number Please enter a valid date Please enter valid credit card information Must be a valid email address

Additional Locations

Location 1

Name Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Address 1 Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Address 2 Required Please enter a valid number Please enter a valid date Please enter valid credit card information

City Required Please enter a valid number Please enter a valid date Please enter valid credit card information

State

Zip Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Location 2

Name Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Address 1 Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Address 2 Required Please enter a valid number Please enter a valid date Please enter valid credit card information

City Required Please enter a valid number Please enter a valid date Please enter valid credit card information

State

Zip Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Location 3

Name Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Address 1 Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Address 2 Required Please enter a valid number Please enter a valid date Please enter valid credit card information

City Required Please enter a valid number Please enter a valid date Please enter valid credit card information

State

Zip Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Location 4

Name Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Address 1 Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Address 2 Required Please enter a valid number Please enter a valid date Please enter valid credit card information

City Required Please enter a valid number Please enter a valid date Please enter valid credit card information

State

Zip Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Location 5

Name Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Address 1 Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Address 2 Required Please enter a valid number Please enter a valid date Please enter valid credit card information

City Required Please enter a valid number Please enter a valid date Please enter valid credit card information

State

Zip Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Location 6

Name Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Address 1 Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Address 2 Required Please enter a valid number Please enter a valid date Please enter valid credit card information

City Required Please enter a valid number Please enter a valid date Please enter valid credit card information

State

Zip Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Location 7

Name Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Address 1 Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Address 2 Required Please enter a valid number Please enter a valid date Please enter valid credit card information

City Required Please enter a valid number Please enter a valid date Please enter valid credit card information

State

Zip Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Location 8

Name Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Address 1 Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Address 2 Required Please enter a valid number Please enter a valid date Please enter valid credit card information

City Required Please enter a valid number Please enter a valid date Please enter valid credit card information

State

Zip Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Location 9

Name Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Address 1 Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Address 2 Required Please enter a valid number Please enter a valid date Please enter valid credit card information

City Required Please enter a valid number Please enter a valid date Please enter valid credit card information

State

Zip Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Location 10

Name Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Address 1 Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Address 2 Required Please enter a valid number Please enter a valid date Please enter valid credit card information

City Required Please enter a valid number Please enter a valid date Please enter valid credit card information

State

Zip Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Billing Address (if different)

Address 1 Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Address 2 Required Please enter a valid number Please enter a valid date Please enter valid credit card information

City Required Please enter a valid number Please enter a valid date Please enter valid credit card information

State

Zip Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Membership Investment

Please note, dues are now a flat fee structure with an annual due date of February 1st. Please select your amount due below, based on the total number of restaurant locations under the same owner/operator or restaurant group.

Membership Type

Primary Directory Category

Number of Locations

Total

The contents of this box are for testing purposes. This box will be removed when the form goes live.

Number of Full Time Employees

Number of Part Time Employees

Number of Rooms

Number of Seats

Number of Associates

Millions in Assets

Enhanced Membership ($50)

Annual Membership Investment

Additional Items

Additional Categories Cost

One-Time Application Fee

Tax

Full-Time Employees Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Part-Time Employees Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Hotel/Motel Rooms Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Restaurant Seats Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Additional Associates Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Additional Associates Cost Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Additional Locations Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Additional Locations Cost Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Assets Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Assets Cost Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Additional Categories Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Number Of Additional Categories Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Additional Categories Cost Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Additional Item 1 Cost Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Additional Item 2 Cost Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Additional Item 3 Cost Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Additional Item 4 Cost Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Additional Item 5 Cost Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Additional Item 6 Cost Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Additional Item 7 Cost Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Additional Item 8 Cost Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Additional Item 9 Cost Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Additional Item 10 Cost Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Annual Dues (charged to card) Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Revenue Item Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Tax (charged to card) Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Fee (charged to card) Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Temp Value For DropDown 1 Required Please enter a valid number Please enter a valid date Please enter valid credit card information

MembershipType Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Additional Item 2

Additional Item 3

Additional Item 4

Additional Item 5

Additional Item 6

Additional Item 7

Additional Item 8

Additional Item 9

Additional Item 10

Additional Directory Categories

Select additional directory categories below by holding the "CTRL" key
Secondary categories may be subject to additional fees

Payment Type

NOTE: If selecting to pay by Check, please do not fill out the Credit Card Information section at the bottom of the form. Thanks.

Credit Card Information

Credit Card Type

Mastercard

Visa

Discover

Amex

Credit Card Number Required Please enter a valid number Please enter a valid date Please enter valid credit card information

Name on Card	Required
Security Code	Required
Valid Through
Address	Required
City	Required
State
Zip	Required
Phone	Required
Credit Card Email Address

Please click submit only one time. The transaction may take several seconds.

Please select a membership type before submitting your application.

Copyright Connecticut Restaurant Association
100 Great Meadow Road Suite 100
Wethersfield, CT 06109
Phone: 860-278-8008
Email: [email protected]

Advocacy
About Us
Members
ServSafe & Industry Training
Foundation
Events
Directory
Legislative Session 2025