Lakeshore Brewers Guild Membership Application Join the Guild Registration form for join the guild Organization Name:* Contact Name:* Membership Type:*(select the appropriate classification for your application)BreweryAllied RetailEnthusiastBrewery Classification:* Microbrewery Brewpub Brewery In Planning Brewer Affiliated Classification:* Supplier Retailer Wholesaler Media Tourism Enthusiast DOB: MM slash DD slash YYYY Enthusiast T-shirt Size: Mailing Address:* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Organization Phone:Contact Phone:*Phone:Email:* Enter Email Confirm Email Liquor License:* State of Where Liqour License Issued:* TTB Brewers Notice #: (If applicable) THE INFORMATION BELOW WILL BE PUBLISHED ONLINE AND IN SOCIAL MEDIABrewery / Retail Address: Public Phone Number:Public Email Address: Website Facebook: Twitter: Instagram: Membership Application FeeBrewery Membership cost: Price: Brewery In Planning Membership cost: Price: Allied Retail Membership cost: Price: Enthuisiast Membership cost: Price: Credit Card*Card Details Cardholder Name