Membership Application

The mission of the Alabama Grocers Association is to promote and support the growth and success of the food industry in the state of Alabama through advocacy, education, public relations and networking.

Membership Application

Company Name (required)*
Contact Name (required)*
Title (required)*
Billing Address*
Street Address Address Line 2 City State ZIP Code
Email*
Enter Email Confirm Email
Website
Company Logo
Max. file size: 100 MB.
Phone
Referred By
Paragraph about your company
Classification*
Number of all Stores (Retailer)
This includes all stores, even out of state stores.
Annual Dollar Volume (Wholesaler)
Retail Classification:
One store: $300.00
Each additional store: $100.00
Up to a maximum of: $4,000.00

Wholesale Classification:
Wholesaler: $1,750.00

Vendor (Price based off of overall sales of the entire company, not just Alabama sales.):
Sales of less than $1 million per year: $350.00
Sales of more than $1 million per year: $700.00
Membership Amount*
Membership Dues Total
$0.00
Credit Card
Card Details
Cardholder Name
Name
This field is for validation purposes and should be left unchanged.