Application

Once you have selected your plan, please fill out the intake form below so we can set up your listing page. Please provide 5-7 business days for processing. Payment must be received before any listing page is processed. Listing pages remain active as long as your membership does.

Full Name *

Company Name *

Email Address *

Location (City, State, Country) *

Company Address

leave blank if online only

Website *

Phone Number *

About Your Company (be detailed) *

Social Media & Content Links (example: https://youtube.com/gamactica, https://twitter.com/gamactica) *

Company Category *

• Dispensary
• Doctor
• Merchandise
• Smoke Shop
• Vape
• Online Shop

select only that apply

Have You Purchased Your Listing Plan? *

• Yes
• No

plans must be purchased prior to listing pages being activated

Are You Interested in SEO Services *

• Yes
• No
• Yes, But Not Now

plans start at $1,000/month - we will contact you accordingly

Are You Interested in Advertising On Our Media/Content Outlets and Disko.TV? *

• Yes
• No
• Maybe

we will contact you accordingly

Submit