Individual Sign Up - Vapor Technology Association

Individual Member Sign Up

THANK YOU FOR BECOMING AN INDIVIDUAL MEMBER AND RAISING YOUR VOICE FOR VAPING! YOUR SUPPORT WILL HELP US WIN THE FIGHT TO SAVE VAPOR!

Please fill out the application below.

Any questions? info@vaportechnology.org

Terms:

$25 / Year

First Name:* First Name Required

Last Name:* Last Name Required

Address Line 1:* Address Line 1 is Required

Address Line 2: Address Line 2 is not valid

City:* City is Required

Country:* Country is Required

State/Province:* State/Province is Required

Zip/Postal Code:* Zip/Postal Code is Required

Cell Phone #:* Cell Phone # is Required

INDIVIDUAL MEMBERSHIP ELECTION: I support the mission of VTA and have decided to join as an Individual Member and offer this application for membership which, I understand, is being reviewed subject to VTA by-laws, rules and policies. If approved, please enroll me as a VTA Individual member for my annual dues of $25.00. I understand that my membership dues are for 12 months.:* INDIVIDUAL MEMBERSHIP ELECTION: I support the mission of VTA and have decided to join as an Individual Member and offer this application for membership which, I understand, is being reviewed subject to VTA by-laws, rules and policies. If approved, please enroll me as a VTA Individual member for my annual dues of $25.00. I understand that my membership dues are for 12 months. is Required

Email:* Invalid Email

Password:* Invalid Password

Password Confirmation:* Password Confirmation Doesn't Match

No val Please fix the errors above