Application for membership in the Arizona Industrial Hemp Council

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“Ditch Weed”
AZ*HEMP
One signature away from legal hemp in Arizona

Please use this form to register your membership in the council. There is no fee to join, however any contribution is appreciated.

Name:


	Phone:

Company:

Address:

City:


	State:


	Zip:

E-Mail:


	Website:


Type of Membership: (Select one)

	Premier Sponsor ($5,000+):

			Sponsor ($2,500-$4,999):

		Founding: ($1,000-$2,499):

				Supporting: ($5-$999):

					Volunteer: ($0):


	Type of business: (Check all that apply)


	Retail:


	Wholesale:


	Consulting:


	Processor:

Producer:


	Marketing:


	Manufacturer:


	Academic:


	Other:


	Comments:


	By clicking the button below to submit my application, I certify that I am authorized to make this application for membership in the Arizona Industrial Hemp Council (AZ*HEMP).