CPSA Membership Billing

Membership Information
Membership Level

Please select your membership level. Membership is tiered to accommodate locally owned package stores of all sizes. (Associate Members are approved by CPSA and promoted in print and digital publications and at events.)

60% of dues may be tax deductible, consult your tax advisor. Membership expires after 1 year.
Legislative Appeal Donation

Please consider a donation to the legislative appeal, which supports our efforts at the State Capitol.
Input Legislative Appeal Amount

Your donation will be added to your final total. Thank you!
Please Select One*
- I am joining for the first time.
- I am renewing my membership.

Account Information
Business Name*
Business Name
Contact Name
First Last
I am the business...
Business Phone*
Mobile Phone
Mobile phones will only be used as a secondary form of contact if there is an urgent billing issue or if the member requests it be their primary form of contact.
Business Address*
Street Address Address Line 2 City State ZIP Code
Email*

Billing Address
Billing Contact*
First Last
Billing Address*
Check if same as Business Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Billing Phone
If different from phone number(s) already provided, please input a billing contact phone number.
Payment Information
Credit Card*

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Total
$0.00

Membership Information