Platinum Member Sign Up

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

Once you fill out your application below, we will send you instructions to complete your dues payment.

Any questions? info@vaportechnology.org

Price:

$100,000 for access until December 31, 2020

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

Business Description:* Business Description is Required

Office Phone #: Office Phone # is not valid

Cell Phone #:* Cell Phone # is Required

PLATINUM 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 my company as a Platinum Member of VTA at the level of $100,000. I understand that our payment would apply to this calendar year. :* PLATINUM 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 my company as a Platinum Member of VTA at the level of $100,000. I understand that our payment would apply to this calendar year. is Required

Email:* Invalid Email

Password:* Invalid Password

Password Confirmation:* Password Confirmation Doesn't Match

No val Please fix the errors above