Membership Application

Join us in creating the future for cannabis in Napa County. We offer three different membership levels and monthly and yearly payment options to best meet your needs.

Full name Please enter your full name.

Phone Please enter your phone.

Address (line 1) Please enter your address (line 1).

Address (line 2 - optional)

City Please enter your city.

State Please enter your state.

Zip Please enter your zip.

Company name

Company description

Company address (line 1)

Company address (line 2 - optional)

How long in operation?

Phone

Website

City

State

Zip

Member Level (select one)

Ally (free)

Supporter ($100/yr)

Associate ($1,000/yr)

Please select one of the member level.

I agree that the information I have provided here is true and accurate. Please select the agreement.