GHTA 2025 Membership Registration Form

GHTA 2025 Membership Registration Form
Is this a membership renewal or new membership?*

RenewalNew Member
Member Type*

VendorService ProviderSales AgencyRetailerOther
Name of Company*
Primary Contact*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Telephone*

Area CodePhone Number
E-mail*
Website*
If you are signing up additional persons from your organization, please provide the new member's information below. If not, please skip to the "How did you hear about us?" section.
2nd Company Member

First NameLast Name
E-mail
Phone Number

Area CodePhone Number
3rd Company Member

First NameLast Name
Additional Member Registration
E-mail
Phone Number

Area CodePhone Number
Type Our company markets products in the following categoriesa question
How did you hear about us?*

AdvertisementArticleTrade ShowFriendAnother GHTA Member

Payment*

Annual GHTA Membership [one-time payment]$650.00

One-time payment; Includes 3 company employees

Additional Member Add-On$100.00

For addition of persons beyond 3 included in your membership.

Quantity

Total $0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Please confirm:

I understand that the yearly dues for membership are the cost associated with the level chosen, and that the dues for each following year are due on 1/1/2026.I have read the Bylaws and the Commitment to Performance and agree to the conditions as stated. I understand that GHTA reserves the right to make the final decision on all membership application.
Should be Empty: