Crosset White Ribbon
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2017 KGCSA Chairman
Lynn Rice
Super Quik, Inc.



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KGCSA Ribbon Payment Page

Please complete the form below to secure your sponsorship.

Note: For payments over $2,000, please select "Check or Money Order" using the "Payment Method" button. We will send you an invoice via email or postal service.

Questions? Please contact Ted Mason at the KGCSA office at 502-696-9153 or  


Please enter the following information:

First Name:
Last Name:
Address Line 1:
Address Line 2:
State (abbrev):
Zip Code:
Phone: xxx-xxx-xxx:
E-mail Address:
Ribbon Sponsorship Level: Diamond Sponsorship  $10,000.00
Blue Sponsorship  $5,000.00
Red Sponsorship  $4,000.00
White Sponsorship  $2,000.00
Special Sponsorship  $1,000.00
Voluntary Retailer Sponsorship  $75.00
Voluntary Retailer Sponsorship  $150.00
Voluntary Retailer Sponsorship  $250.00
Payment Method

Kentucky Grocers Association (KGA)/Kentucky Association of Convenience Stores (KACS)
512 Capitol Avenue, Frankfort, KY 40601, Phone: 502-696-9153, Fax: 502-875-1595 Email:

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