EmailMeForm
AVCA Affiliate Partner Online Membership Form
*-Required
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New Membership
Membership Renewal
Name
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First
Last
Coaching Title
*
Email Address
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School Name/Org
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CHOOSE YOUR STATE AFFILIATION:
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Please select
IHSVCA-Indiana
MAVCA-Massachusetts
MIVCA-Michigan
MNVBCA-Minnesota
MHSVCA-Missouri
NMHSCA (VB) - New Mexico
OHSVCA-Ohio
SDVBCA-South Dakota
WVCA-Wisconsin
NOT SURE
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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Home Address
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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
AVCA AFFILIATE PARTNER STATE ASSOCIATION DISCOUNTED MEMBERSHIP
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High School/Interscholastic Membership - $80.00
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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.
Comment/Question (max 500 Characters)
CLICK RECAPTCHA AND THEN CLICK THE SUBMIT BUTTON BELOW ONE TIME TO BE REDIRECTED. CLICK DEBIT/CREDIT FOR CHECK PAYMENTS ALSO. LEAVE CARD INFO BLANK IF PAYING BY CHECK.
Total
$0.00
