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Food Handler Certificates ONLINE

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food handler
alcohol server
Training

SPONSORSHIP
 

APPLICATION FOR MEMBERSHIP
First Name: Last Name: Date:  
Owner or Operators Name:
 2/9/2010
Title:
Sponsored by:
  First Name: Last Name:
Second Contact Name:
             
Second Contact Title:
Doing Business As (name of your establishment)
Corporate Name (legal entity)
Location (address)
City
 State Zip
Mailing Address (if different)
City
 State Zip
County Business Phone Fax
WEB Site Address Email
Please check the boxes for the endorsed services for which you would like information sent? (some conditions may apply)
Liberty Northwest - Workers Compensation Insurance Paychex - Payroll Processing and Tax Preparations
Liberty Northwest - Property and Liability Insurance Standard Biodiesel - Waste Vegetable Oil Recycling
ORA Health Insurance Program - Garth T. Rouse &Associates Careington - Discount Health Services
Micros - Point of Sale Systems AFLAC - Supplemental Health Insurance
Take Charge - Credit Card Processing Creative Center - Graphic Design and Marketing
BMI - Music Licensing
OLCC License Type Do you own additional locations? Please check one
Full On-Premises Sales Yes
Franchise
Limited On-Premises Sales No Chain
No OLCC License If Yes, how many? Independent
Banquet Capacity: 50-7576-150151-250251-400
Industry Segments
In an effort to best serve every member of the food service industry, the ORA has identified
segments that comprise the industry in Oregon. Please check the box for the industry segment
that represents your business.
Fine DiningQuick ServiceCasual/Family DiningBar & Tavern Entertainment

 

 

 
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