EmailMeForm
GVCA - AVCA Signature Affiliate Membership
*-Required
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New Membership
Membership Renewal
Name
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First
Last
Coaching Title
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Email Address
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School/Organization
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School Address
*
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Phone
*
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####
Mobile Phone
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-
###
-
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Home Address
*
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
For my mailing address, please use my:
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School Address
Home Address
(Includes GVCA membership & AVCA HS/Interscholastic Membership)
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High School/Interscholastic Membership - $95.00
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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.
Questions or Share A Note with GVCA board (100 words or less):
**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
