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Call: 859-219-3571 | Email: kpma@kpma.org

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KPMA Marketer Membership Application

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KPMA Marketer Membership Application

Jobber membership dues are assessed on a volume (combined gasoline and diesel sales in Kentucky for the previous 12 months) basis, in gallons/year. Please see below for dues amounts, and select which reflects your company's records for the year:
*
- Less than 1.5 million - $535
- 1.5 - 2.5 million - $625
- 2.5 -3.5 million - $935
- 3.5 - 4.5 million - $1,245
- 4.5 - 5.5 million - $1,560
- 5.5 - 6.5 million - $1,870
- 6.5 - 7.5 million - $2,180
- 7.5 - 10 million - $2,495
- 10 - 15 million - $2,675
- 15 - 20 million - $2,970
- 20 - 25 million - $3,265
- 25 - 30 million - $3,565
- 30 - 40 million - $3,860
- 40 - 50 million - $4,160
- 50 - 60 million - $4,455
- 60 - 70 million - $4,750
- 70 - 80 million - $5,050
- 80 - 90 million - $5,345
- 90 - 100 million - $5,645
- More than 100 million - $5,940
Membership dues are prorated to the calendar month in which you join. Complete this form and mail a check for dues to Kentucky Petroleum Marketers Association, 2365 Harrodsburg Road, Suite A325, Lexington, KY 40504, or we will invoice you for the amount of your membership upon the receipt of this form.
Name*
First Last
Job Title
Company*
Company Address*
Street Address Address Line 2 City State ZIP Code
Is this address also your billing address?*
- Yes
- No
Billing Address
Street Address Address Line 2 City State ZIP Code
Phone*
Fax
Email*
Enter Email Confirm Email
Website*
Description of Products*
How did you hear about us?
After submission of this form, KPMA will email you a copy of your invoice.

Questions? Contact KPMA at 859.219.3571 or email kpma@kpma.org.
Name
This field is for validation purposes and should be left unchanged.

For more information on how to join KPMA, please contact us.

Email: kpma@kpma.org
Call: (859)226-4382

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The mission of the Kentucky Petroleum Marketers Association (KPMA) is to promote the interest and goodwill of members, to sustain and enrich relationships, and to advance the industry.

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Kentucky Petroleum Marketers Association

2365 Harrodsburg Road
Suite A325 Lexington, KY 40504
Call: 859-219-3571
Email: kpma@kpma.org

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