To apply for membership, please fill out the form below.
The Board of Directors carefully screens all applicants, reserving the right to deny membership to non-qualified candidates.


  Business Information

*Company Name
*Position/Title

Web Site Address

Are you an Employee of a cable, satellite, telephone or Internet company?
Are you a Consultant to a cable, satellite, telephone or Internet company?
Are you a State/Regional Association?

Company Description
  Contact Information

*First Name
*Last Name
*Address
*Zip
*Phone
Fax
*Email

NOTE: your email will serve as your
username when logging in.
CHOOSE A PASSWORD
*Password
*Verify Password
  Additional Information

How did you hear about us?/Additional Comments.
  Billing Information

*Payment Method


If you are paying by check, you don't need to fill out the fields below.
PLEASE MAKE CHECKS PAYABLE TO: Broadband Tax Institute
The Broadband Tax Institute is a Non-Profit Corporation.
*Billing Name
*Address
*Zip
*Card Type
*Card Number
*Expiration (mm/yyyy)
CVV Code/Card ID (see example -->)
What is a CVV Code/Card ID?
The Card ID is to help with the security of using your credit card. Below are 2 examples of where you can find the Card ID based on what type of card you are using.
AMEX
Visa/Mastercard
Your card will be charged: $275 and does NOT auto-renew.
THIS INCLUDES; the annual membership fee of $175 and a $100 (one-time only) initiation fee.



TERMS AND CONDITIONS:
*By submitting this form you agree to accept the Code of Ethics of BTI
Annual membership dues are $175
New members will be charged a one-time $100 initiation fee.

*All memberships expire and are due for renewal on January 1st of each year.

The BTI Organization is not responsible for the accuracy of any information appearing on its web site and is not liable for any damages, direct or indirect, incurred by any party as a result of use of or reliance on such information.