Become a Member Lorem ipsum dolor sit amet, consectetur adipiscing elit. Ut elit tellus, luctus nec ullamcorper mattis, pulvinar dapibus leo. Lorem ipsum dolor sit amet, consectetur adipiscing elit. Ut elit tellus, luctus nec ullamcorper mattis. Membership Form First Name* Last Name* Phone Number * Your Email Business Name * Business Website (Optional) * Are you Applying for a Social Equity License? YesNo If yes, what kind of social equity applicant are you? (optional) * If yes, what kind of Social Equity Applicant are you? (optional) YesNo Do you hold a New York State Adult use License? YesNo Country / Region United States (US) Street Address * Town / City * State * AlabamaAlaska Postcode / Zip * County *