Select the association you wish to join:
	Digital Signage Association (DSA) Self-Service & Kiosk Association (SSKA) Both DSA and SSKA
Membership Type: (see pricing chart above) SELECT ONEVendor (1-9 employees)Vendor (10-29 employees)Vendor (30-99 employees)Vendor (100 or more employees)DeployerIndividual
Board Representation Options: Requires paid membership in appropriate Association
	No Board Representation DSA Board Representation - $1000 per year SSKA Board Representation - $1000 per year Digital Technology Alliance Board Representation - $1500 per year**
**Includes DSA and SSKA Board Representation
Sponsorship Options: Requires paid membership in appropriate Association. All sponsorships include Board Representation.
	No Sponsorship DSA Sponsorship - $5000 per year SSKA Sponsorship - $5000 per year Digital Technology Alliance Sponsorship - $7500 per year***
***Includes DSA and SSKA Sponsorships
COMPANY/ORGANIZATION INFO
Company Name:  *
Address 1:  *
Address 2:
City:  *
State/Province:
Zip/Postal Code:  *
Country:  *
Phone:  *
Website:  *
Brief Company Description:
PRIMARY CONTACT
First Name:  *
Last Name:  *
Job Title:  *
Email Address:  *
ADDITIONAL CONTACT 1
First Name 1:
Last Name 1:
Job Title 1:
Email Address 1:
ADDITIONAL CONTACT 2
First Name 2:
Last Name 2:
Job Title 2:
Email Address 2:
PAYMENT INFO
You will be invoiced for all applicable fees and dues. Your benefits will begin when the invoice is paid in full.

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