Imperial Court of Kentucky Membership

Imperial Court of Kentucky. Membership Application

Complete the form below to sign up for membership.
Legal Name*

First NameLast Name
Pseudonym/Drag name
Preferred Name
Pronouns (when performing/in drag)
Pronouns (when not performing/not in drag)
Describe your race/ethnic background (This information is used for demographic data collection only. Your responses are kept private and secure. This information will not be used for discriminatory purposes. You can change this information at any time by emailing at membership@imperialcourtofkentucky.org)

African American/BlackCaucasian/White, not HispanicCaucasian/White, HispanicAsian/Island PacificIndigenousLatinxOther
Describe your gender identity
Age
Please list any honorifics/titles you have here.
Any special talents you can bring to the organization (DJ, graphic design, etc)
E-mail*
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Additional Household Members

	First Name	Last Name	Pronouns	Preferred Name	Pseudonym
Second Household Member
Third Household Member
Forth Household Member
Fifth Household Member

Membership Rules
- No application for membership will be accepted without full payment of dues. New member and renewal dues are $10, due upon joining and then renewed every year on or before December 31.
- Checks and money orders should be made payable to Imperial Court of Kentucky, INC. if mailing your application and dues, DO NOT mail cash. Payment in the form of personal check or money order must be used for mailed application.
- Application submission and all other organization correspondence should be sent to: Imperial Court of Kentucky, INC,PO Box 265, Lexington, KY 40588-0265.
- All applicants for full membership status must verify that they are a resident of the Empire of the organization and at least 18 years of age by a valid state issued photo ID. If submitted by mail, please enclose a copy of this ID.
- The Imperial Court of Kentucky is recognized as a tax-exempt public charity, 501(c)3, by the IRS and the Attorney General of Kentucky. Membership dues are collected for the sole purpose of furthering the mission of the organization.
Please check here to confirm*

I have read, understood, and accepted the rules for membership.
Please upload a copy(s) of your drivers license to verify date of birth and proof of residence.
Once you submit your application, we will contact you to let you know your membership application has been accepted.

Thank you!
Copy of Driver License*

Cancelof
Membership*

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USDMembership is $10 per member. Please update amount times the number of household members
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Imperial Court of Kentucky. Membership Application

Membership Rules