Supplier Application

Supplier: A company that supplies products or services to TPA Associate members, which help those manufacturers bring their product(s) to market. Examples include: tobacco growers; cigar box makers; cigar band or cellophane wrapper makers; pipe tobacco can makers; insurance providers; software providers, and media companies.

Required Documentation: Suppliers must be sponsored by at least one (1) Associate member as part of the application process. Indicate the sponsoring associate member(s) on your application. TPA will verify prior to approving membership.

AFTER SUBMITTING YOUR APPLICATION, YOU WILL BE REDIRECTED TO THE PAYMENT PAGE
NO APPLICATIONS WILL BE PROCESSED WITHOUT FULL REMITTANCE.

First Name *

Last Name *

Company

Email *

Phone *

Address *

City *

State *

Postal Code *

Country *

Website *

Which membership are you applying for?

Industry Partners applying for membership should have established relationships with at least 1 current PCA Associate/Manufacturer member. Provide the name(s) of those companies here. If none is available, provide an explanation.

Sponsoring PCA Associate Members (company names)

1.
2.
3.

No Established Relationship Explanation

How many employees work for your company (including yourself)? *

Social Accounts

Facebook
Instagram
Twitter
LinkedIn
YouTube
Google Business Profile

Were you referred by someone?

Referrer Member name

I Consent to Receive SMS Notifications, Alerts & Occasional Marketing Communication from company. Message frequency varies. Message & data rates may apply. Text HELP to (XXX) XXX-XXXX for assistance. You can reply STOP to unsubscribe at any time.

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AFTER SUBMITTING YOUR APPLICATION, YOU WILL BE REDIRECTED TO THE PAYMENT PAGE
NO APPLICATIONS WILL BE PROCESSED WITHOUT FULL REMITTANCE.