EmailMe Form - Membership Application

Membership Information

Review the NC TECH membership category descriptions and rate chart HERE to determine which most closely fits your company/organization.

NC TECH
Membership Category/
# of Full-Time NC Employees

Select your membership category and full-time NC employee range to determine annual dues investment (For "Technology Consumers" and "Affiliates" use your IT headcount in NC.)

NC TECH for STARTUPS
Membership Category/
# of Full-Time NC Employees

Are you a tech startup? Startups are eligible for a one-time $250 credit (made possible by Packard Place, an entrepreneurial hub based in Charlotte) toward the first year of membership dues. If your company meets ALL of the following criteria use the NC TECH for STARTUPS option above: Qualify for the Technology member category; Headquartered in NC; Legally formed within the last 4 years; Fewer than 20 employees. Startups must pay dues by credit card rather than to request an invoice.

Please add a Board of Advisors Seat:

I'm ready to join the Board of Advisors - activate my seat and invoice me accordingly

I'm interested, but I have some questions - please contact me to discuss

Not at this time

(See Advisors program description, fee and current roster HERE)

If adding Board of Advisor:
Advisor Name/Job Title

How did you hear about NC TECH? *

Hold CTRL key and select as many as applicable

Write in for referral or other

What is your motivation(s) for joining? *

Hold CTRL key and select as many as applicable

Write in for other

Primary Contact Information

The primary contact is considered the key business contact for NC TECH and listed in the online member directory.

Primary Contact Name *

Title *

Email *

Phone *

Key Contacts

If applicable, please add these additional business contacts who we can engage in membership activities:

Billing Contact Name (if should be different than Primary)

Title

Email

Phone

Marketing Contact Name

Title

Email

Phone

CIO or IT Contact Name

Title

Email

Phone

CISO or Security Contact Name

Title

Email

Phone

HR or Talent Acquisition Contact Name

Title

Email

Phone

Community or Government Affairs Contact Name

Title

Email

Phone

All employees are eligible to receive member benefits and participate in NC TECH activities. Please upload a list of employees to add to the database to ensure they receive a welcome, member portal login and email communications (include Name, Title, Email, and Phone).

Employee List
(optional)

Payment Information

Total Amount Due

Please complete total amount due based on annual dues investment plus optional Board of Advisor seat.

Preferred Payment
Method *

Credit Card (Complete secure form below) *

Check (Made payable to NC TECH)

Invoice (Will be sent to primary contact unless otherwise noted below)

Credit card info will be transmitted securely, but charged only after info is verified. A receipt will be sent to the email address you provide below.

Name on Credit Card

First Last