Keystone Member Sign Up

JOIN VTA TODAY!

THANK YOU FOR AGREEING TO BE A KEYSTONE MEMBER AND BECOMING A CHAMPION IN THE FIGHT TO SAVE VAPOR!

Please fill out the form below to complete your application and pay your membership dues.

Any questions?  info@vaportechnology.org

Terms:

$1,000 / 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

Email:* Email is Required

Company Name:* Company Name is Required

Business Description:* Business Description is Required

Device Manufacturer Liquid Manufacturer Flavor Supplier Retail Shop(s) Importer Online Seller State Vapor Association Other

Office Phone #: Office Phone # is not valid

Cell Phone #:* Cell Phone # is Required

MEMBERSHIP ELECTION: I have read the membership descriptions on the VTA Membership Classes form 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 Member or Friend of VTA. I understand that our payment would apply to the calendar year 2020.:* MEMBERSHIP ELECTION: I have read the membership descriptions on the VTA Membership Classes form 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 Member or Friend of VTA. I understand that our payment would apply to the calendar year 2020. is Required

Yes

Email:* Invalid Email

Password:* Invalid Password

Password Confirmation:* Password Confirmation Doesn't Match

Authorize.net

Pay with your credit card via Authorize.net

Bank Wire Transfer ACH Click Here

If you would like to send your payment in the form of a Bank Wire transfer please send an email to: tucker@vaportechnology.org

No val Please fix the errors above