Partner Application

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Partner Membership Application

Any alcohol industry related manufacturers, wholesalers or distributors that services or sells alcohol industry-related product. This form serves as an application for MULBA membership. Simply complete the form and click the submit button at the bottom of the page to send your application electronically. If preferred, you may also print, complete and fax or mail this form to:

Maryland Unified Licensees Beverage Association, Inc.

8908 Liberty Road, Randallstown, MD 21133
Phone: (410) 521-7001*** Fax: (410) 521-9742
Email: info@Mulba.org

Type	Member Dues
Partner	$ 250.00/Year
Trading as: (very important)
Your Name:
Your Title:
Your Street Address:
City:
State/Zip	/
County:
Business Phone:
Fax:
E-Mail:
URL:
Mailing Address: (if different from above)
City:
State/Zip	/
Products/Brands:
Please describe your company in 25 words or less.
Other
Please contact me regarding obtaining a business web page on MULBA.org