VRA 2012 Conference Registration

Please use the form below to register for the 2012 VRA Conference and/or VRA membership. Conference attendees are eligible for reduced membership fees/renewals. After clicking the Submit button below, you will see the VRA Shopping Cart where you can make your selection and checkout. Use the shopping cart to submit secure online credit card payments (Visa, MasterCard, Discover, American Express, eChecks) via PayPal for membership, conference fees and donations.

If you would prefer to send in payment, please download the regular membership form or conference registration form, which includes membership discounts for conference attendees.

The Benefits of Logging into the VRA Web Site

To automatically fill in portions of this form with your member data, please login to the VRA Web site if you are an existing member. This link will log you in and return you to this screen. If you have forgotten your Password, enter your Username to have your password e-mailed to you. Username is typically first initial and last name, i.e. jsmith.
If you would like to check your membership status, please contact vra@vrarecycles.org or (804) 302-4231.

First Name:*

Last Name:*

E-mail:*

Title:

Organization:

Address1:

Address2:

City:

State:

Zip Code:

Phone:

FAX:

Conference Registration Type (you will select items for payment on next screen):

Will you be renewing or creating a new VRA membership at Conference discount rates (you will select items for payment on next screen)?
Yes
No

Do you need a vegetarian option for lunch?*
Yes
No

Please select any additional activities that you will be attending - Ctrl-Click selects multiple items (you will select items for payment on next screen if necessary):

"Ctrl-Click" Selects Multiple

Additional Comments:

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Submit

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VRA 2012 Conference Registration