Membership Application - New Hampshire Tech Alliance

Instructions

Please complete the following questions.

Select An Option

Enterprise New Membership $4000 Annually

Annual Revenue: $25M+

Advanced New Membership $2500 Annually

Annual Revenue: $10M - $25M

Academic & Municipal New Membership $1000 Annually

Membership is only for academic or municipal institutions

Accelerator New Membership $1000 Annually

Annual Revenue: $3M - $10M

Affiliate/Partner New Membership $1000 Annually

Contact for more details

Innovator New Membership $750 Annually

Annual Revenue: $500k - $3M

Basic New Membership $500 Annually

Annual Revenue:$0 - $500k

Individual New Membership $150 Annually

This membership is only for remote employees or retired individuals

Enter Contact Information

Prefix (i.e. Mr. Mrs. Dr.)

First Name

Last Name

Suffix (i.e Jr. Sr. III)

Designations

E-mail

Family NameBusiness Name

Please select a valid membership option and fee item if exist