Personal Membership

All members must be 19 years of age or older to purchase from our dispensary.

Please Complete the Required Fields Below and Upload 2 clearly scanned pieces of government ID (one of which must have a photo).

First Name (required)

Last Name (required)

Valid Email Address (required)

Contact Phone Number (required)

Address (required)

Government ID (required)

We will only ship to the address provided on your government ID

One of these must have a picture

Maximum file upload size | 10 MB

1.

2.

Additional Message

I accept the MOTA Codes of Conduct.

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