Current Member InformationCompany/Organization Name* HiddenMHTA Member ID Changes in Information My information has not changed I need to update my information Update Company/Organization InformationPlease update any information that has changed for your company or organization. If you are unsure if we have your current information, please enter it below and we'll compare to what we have on file.Company/Organization Name Parent Company/Organization President/CEO Key Contact Name First Last Title Email PhoneMarketing/ Communications contact & email* Address Street Address Address Line 2 City Select a StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Mailing Address Same as above Street Address Address Line 2 City Select a StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code WebsitePlease include the "http" or "https" Number of EmployeesIndustryselect oneAudio/VisualAdvertising/MarketingAgricultureBankingBiotechnologyChemicalsComputers/HardwareConstructionConsultingEducationElectronicsEnergyEngineeringEnvironmentalFinanceFood & BeverageGovernmentHealthcareHospitalityInsuranceIT ServiceLegalManufacturingMediaMed TechNot for ProfitOtherReal EstateSoftwareStaffing/SearchTelecommunicationsTransportationVenture CapitalWeb DevelopmentMembership InformationAssociation Involvement ActivitiesMembership dues apply to all employees. Becoming active in MHTA is the best way to get a return on your investment. Please let us know how you would like to be involved in MHTA programs, events and initiatives by checking up to three (3) activities. Attend Events/Networking Visibility within community Marketing/Sponsor events Professional Development Advocacy/Public Policy – Federal Advocacy/Public Policy – State Advocacy/Public Policy - Local STEM Education Sales/Business Development Membership Category*select oneTechnology ProducersTechnology Application UsersAncillary Service FirmsNonprofits & Public EntitiesTechnology Producers*Examples Include: Manufacturing, software, engineering, telecom, datacom, consulting. After selecting your category, please select your company’s Minnesota gross revenues.select one$0 - $100k$100k - $500k$500k - $1m$1m - $2m$2m - $5m$5m - $10m$10m - $25m$25m - $50m$50m - $100m$100m - $250m$250m+Technology Application Users*Examples Include: Sales and service organizations, utilities, financial institutions. After selecting your category, please select your company’s Minnesota gross revenues.select one$0 - $500k$500k - $2m$2m - $5m$5m - $10m$10m - $25m$25m - $50m$50m - $100m$100m - $250m$250m+Ancillary Service Firms*Examples Include: Legal, accounting, venture firms, real estate. After selecting your category, please select your company’s Minnesota gross revenues.select one$0 - $500k$500k - $2m$2m - $5m$5m - $10m$10m - $25m$25m - $50m$50m - $100m$100m - $250m$250m+Nonprofits & Public Entities*Examples Include: Economic development organizations, government agencies, educational institutions. Please select your organization's annual budget.select one$0 - $500k$500k - $2m$2m - $5m$5m - $10m$10m - $25m$25m - $50m$50m - $100m$100m - $250m$250m+MnTech DuesYour annual MnTech dues are based on your estimated 2020 Minnesota gross revenue, or for nonprofits & public entities, your annual budget. $0.00 CommentsPlease use this field for any questions, comments or additional requests. Someone will be in touch with you shortly.Payment InformationMethod of Paymentselect oneCredit CardBilling Email*Please enter the email address of an individual to receive the payment confirmation email. Billing Address* Street Address Address Line 2 City Select a StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Credit Card Information American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Month010203040506070809101112 Expiration Year20222023202420252026202720282029203020312032203320342035203620372038203920402041 Expiration Date Security Code Cardholder Name NOTE: For federal tax purposes, a portion of your payment may be deductible as an ordinary business expense. However, the portion allocable to lobbying activities is not. Using methods required by federal regulations, we reasonably estimate this portion of your annual dues payment to be 12%.MnTech Dues $0.00 Email Address*Please enter the email address of an individual to receive the confirmation email. CAPTCHA
