Kona Coffee Council Membership Application

Kona Coffee Council - Application for the Estate Program

To apply, please print and complete this page, and mail it to:

Bill Dwyer
P.O. Box 2440
Kealalakekua, Hawaii 96750

Estate Name:

Owner's Name:

Mailing Address:

Daytime Phone:

Evening Phone:

Fax:

EMail Address:

Website URL:

Ownership Interest:

(Fee Simple, Bishop, Private Lease)

Manager's Name:

(If different from owner)

Manager's Mailing Address:

Daytime Phone:

Evening Phone:

Fax:

Estate Size in Acres:

Property Address/Location:

Property TMK:

KCC Sub-District Designation:

Location of Pulping Mill:

Location of Green Mill:

Projected Average Annual Harvest (Cherry Weight)

The above is true and correct to the best of my knowledge

Signature:

Owner/Title:

Date:

� 2007 Kona Coffee Council

Estate Name:
Owner's Name:
Mailing Address:


Daytime Phone:
Evening Phone:
Fax:
EMail Address:
Website URL:
Ownership Interest:
	(Fee Simple, Bishop, Private Lease)
Manager's Name:
	(If different from owner)
Manager's Mailing Address:


Daytime Phone:
Evening Phone:
Fax:
Estate Size in Acres:
Property Address/Location:


Property TMK:
KCC Sub-District Designation:
Location of Pulping Mill:
Location of Green Mill:
Projected Average Annual Harvest (Cherry Weight)

	The above is true and correct to the best of my knowledge

Signature:
Owner/Title:
Date: