Request for Artisan Application
Form
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| Please provide the following
information. |
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| Name: |
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| Company: |
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| Address: |
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| City: |
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| County: |
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| ZIP: |
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| Daytime Phone: |
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| Evening Phone: |
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| E-mail: |
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| Business Web site: |
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| Products you make/create(if
applicable) |
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| Are you currently a resident
of Kentucky?If not, please contact
our office before proceeding. |
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| Are you 18 years or older? |
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| To help us forward the correct
applications, please check in what way(s) you would like to work with our
center: |
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