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Membership Application

"*" indicates required fields

This will serve as a letter of intent of the organization listed below and hereinafter referred to as Prospective Member, to join the Secure Technology Alliance, a not-for-profit multi­-industry member organization, with rights, privileges and responsibilities detailed in the bylaws of the Secure Technology Alliance. All items marked with asterisk (*) are required.

Organization Details

Address*
Please attach logo (Max file size 512MB - .jpg .gif .png .pdf)
Accepted file types: jpg, gif, png, pdf, Max. file size: 50 MB.
Permission to include company name on membership lists for general marketing purposes*
Permission to provide link from Secure Technology Alliance site to your organization's website*
Member qualifications and benefits vary by membership level as described at Membership Information : Membership Levels. Membership dues are based on member’s annual revenue.

Select Desired Membership Level and Dues Tier Based on Annual Revenue

Select only one
Leadership (revenue = dues)
Principal (revenue = dues)
General (revenue = dues)
Associate
Individual
Acknowledgment*
Bylaws Agreement*

Details of your Industry, Products Offered, and Markets Served

Industry Classification*
(Select all that apply)
Products Offered*
(Select all that apply)
Markets Served*
(Select all that apply)

Payment Details

Upon approval of the application, the Alliance will send the new member an electronic invoice. Payment may be made by credit card, wire transfer, or check. Instructions for each payment method will be included with the electronic invoice.

Member Primary Point of Contact

Name*

Alternate Point of Contact

Name*

Please list the referring Secure Technology Alliance member that led you to join, if applicable

Name
If you have any questions or issues while filling out the form, please email Jay Armocilla: [email protected] or download the application and email to Jay Armocilla.
This field is for validation purposes and should be left unchanged.

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