Membership Application Request

To request an application for CTEPA membership, simply fill out our form. All information is required. Name: Organization Name: Type of Organization:   African Americans American Indians/Alaska Natives Asian/Pacific Islanders Business Community Colorado-Based Organizations Colleges and Universities (targeting college students) Faith Community Gay, Lesbian, Bisexual, and Transgender Population Hispanics Women Address: City: State: Zip Code: e-mail: Phone: The information gathered by this form will be used solely by The Colorado Tobacco Education and Prevention Alliance.