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Become an Associate Member Form

by VMDAEC | Oct 24, 2022 | Associate Membership Form | 0 comments

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"*" indicates required fields

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Yes, I would like to become a VMDAEC Associate Membership*

Yes

SUBSCRIPTIONS (Click to open)

As part of your membership, you are eligible for complimentary subscriptions to a digital edition of our magazine, Cooperative Living and the CONNECTIONS digital member newsletter for up to five people in your organization. Please provide the subscription information below.

Name - (please type none if you do not wish to receive this benefit)

Email

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Select items you wish to receive:

Cooperative Living - Digital Edition

CONNECTIONS member e-newsletter

Add

a 2nd subscriber

done

Name

First Last

Email

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Select items you wish to receive:

Cooperative Living - Digital Edition

CONNECTIONS member e-newsletter

Add

a 3rd subscriber

done

Name

First Last

Email

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Select items you wish to receive:

Cooperative Living - Digital Edition

CONNECTIONS member e-newsletter

Add

a 4th subscriber

done

Name

First Last

Email

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Select items you wish to receive:

Cooperative Living - Digital Edition

CONNECTIONS member e-newsletter

Add

a 5th subscriber

done

Name

First Last

Email

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Select items you wish to receive:

Cooperative Living - Digital Edition

CONNECTIONS member e-newsletter

VMDAEC Associate Membership

Price:

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Payment Method Options*

Check

PayPal

Total

Make check payable to VMDAEC Mail to: VMDAEC 4201 Dominion Boulevard, Suite 101 Glen Allen, VA 23060

To pay online using PayPal go to: PayPal.me/VMDAEC

BILLING (Click to open)

An invoice will be emailed for the $2000 associate membership fee and benefits will begin once the full payment is received. Please provide the billing information below.

Name*

First Last

Billing Email*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Δ

Back to Membership Details

CONTACT US

Address: 4201 Dominion Blvd. Glen Allen, Virginia 23060
Phone: (804) 346-3344
E-mail: [email protected]

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Become an Associate Member Form

COMPANY INFORMATION

SUBSCRIPTIONS (Click to open)

BILLING (Click to open)

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