Registration Form
VBCOA 86th Annual School and Conference
September 13-15, 2015
The Wyndham Virginia Beach Oceanfront, 5700 Atlantic Avenue, Virginia Beach VA 23451
To register by check payable to VBCOA, mail with this completed form to Sherall Dementi, VBCOA, P. O. Box 12164, Richmond, VA 23241. A purchase order may be given in order to allow your registration to be processed without waiting for the check. Questions: call 804/649-8471. Fax: 804/343-3758.
The on-line conference registration process is not yet open, but it will be. Please wait to register if you would prefer paying by credit card.
Name
First Name as It Should Be on Name Tag
Title & Locality
Address
E-mail address
Spouse/Companion/Guest Name (if attending)
I will attend the Region VIII picnic on Saturday, Sept. 12 (no additional charge): ___ yes ___ no
Please notify me by email on an updates to the schedule: ___ yes ___ no
Registration Fee-please check fee; please note that tickets will be collected at meal functions.
Register either for a full or partial registration: VBCOA VBCOA
Member Non-Member Companion
Full Registration $175 $250 $75
(All meetings, including banquet)
& preconference activities)
OR
Partial Registration
Monday (does not include banquet) $100 $140
Tuesday $100 $140
Total Fees $_____
You may register on-line at www.vbcoa.org OR register by mail or fax or email. If registering by mail or fax or email please indicate whether you will pay by enclosed check OR upon arrival (check or cash only) OR check to come by mail. Make checks payable to VBCOA. Registration fees are refunded if cancellation notice is received by Sept. 7.
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