EmailMeForm
AVCA - NCVBCA Signature Affiliate Membership Form
*-Required
IMPORTANT: This membership form is being discontinued. To join or renew your NCVBCA/AVCA Signature Affiliate dual membership, please visit avca.org/join-us. All new and renewing high school members may now complete registration directly through the AVCA website, where you can select your state-specific membership option, activate your dual membership benefits immediately, and choose whether to enroll in automatic renewal.
Join/renew at avca.org/join-us.
*
New Membership
Membership Renewal
Name
*
First
Last
Coaching Title
*
Email Address
*
School/Organization
*
School Address
*
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Phone
*
###
-
###
-
####
Mobile Phone
###
-
###
-
####
Home Address
*
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
For my mailing address, please use my:
*
School Address
Home Address
(Includes NCVBCA membership & AVCA HS/Interscholastic Membership)
*
High School/Interscholastic Membership - $95.00
*
PAY BY CHECK (Payable to "AVCA"; Mail to: AVCA, 2365 Harrodsburg Rd, Suite A325, Lexington KY 40504-reCAPTCHA-CLICK SUBMIT)
PAY BY CREDIT CARD (reCAPTCHA - CLICK SUBMIT - You will be redirected to PayPal to enter CC info and complete the transaction)
WOULD YOU LIKE TO ENROLL IN AUTO RENEWAL?
YES, I would like to learn how I can opt into auto renewal of my membership.
Comment/Question (max 500 Characters)
**YOU WILL BE RE-DIRECTED TO PAYPAL TO COMPLETE TRANSACTION. IF PAYING BY CHECK, CLICK DEBIT/CREDIT ALSO. LEAVE CARD INFO BLANK AND CLOSE OUT OF THE ONLINE FORM. A COPY or CONFIRMATION OF THE COMPLETED ONLINE FORM WILL BE EMAILED TO YOU. PLEASE CHECK YOUR SPAM/JUNK FOLDER JUST IN CASE.
Total
$0.00
