CONFERENCE REGISTRATION

Only members and guests that have completed this form and pre-paid the registration fee will be seated at the Conference.

First Name(*)
Please enter your first name.

Last Name(*)
Please enter your last name.

Title
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Name on the Badge

Spouse Name (If attending)
Please enter your spouses name.

Company(*)
Please enter your company name.

Address(*)
Please enter your address.

City(*)
Please enter the city name your company is located in.

State(*)
Please select your state.

Zip Code(*)
Please enter your zip code (first 5 digits only).

Phone Number(*)
Please enter your phone number.

Fax Number
Please enter your fax number.

Cell Phone
Please enter your cell phone number.

Publish Cell Number?
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Email Address(*)
Please enter your email address.

Type of Registration(*)

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ADDITIONAL ATTENDEES

Number of Additional Attendees:
Please select how many additional attendees you will be registering.

Additional Attendee 1
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Address, City Zip Code (If Different)
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Direct Line
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Email:
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Cell Phone
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Publish Cell Number?
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Additional Attendee 2
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Address, City Zip Code (If Different)
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Direct Line
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Email:
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Cell Phone
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Publish Cell Number?
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Additional Attendee 3
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Address, City Zip Code (If Different)
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Direct Line
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Email:
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Cell Phone
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Publish Cell Number?
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Additional Attendee 4
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Address, City Zip Code (If Different)
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Direct Line
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Email:
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Cell Phone
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Publish Cell Number?
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If you have more Additional Attendees, please click to download the form and email to: webmaster@cvta.org .

EXHIBITORS

Please make sure to submit your full-size or vector logo if you are exhibiting. We will use it to make an exhibitor piece.

Upload Your Logo - EXHIBITORS-ONLY
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Exhibitor Promotional Piece
Please enter a promotional piece for your company if you are exhibiting.

SPONSORSHIP

Are you interested in
Sponsorship Opportunities?

You may sponsor all or part of a conference function. Please contact Cindy Atwood 703-642-9444 or ccatwood@cvta.org.

PAYMENT INFO

All Payment must be made before Conference.

Payment Method(*)

Please select your payment method.

Credit Card Users: A 4% processing fee will be applied to payments made using American Express, and a 3% processing fee will be applied to payments made using Visa, MasterCard, or Discover.

Credit Card Number
Please enter your credit card number without dashes.

Name on Card
Please enter the name on the credit card.

Expiration Date
Please enter the expiration date of your credit card.

Billing Address
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City
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State
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Billing Zip Code
Please enter the billing zip code for your credit card.

Terms and Conditions(*)
You must accept the terms presented to register online.

By clicking here, I understand that CVTA will charge my credit card for the above checked items (if selected). If a mistake is discovered, I can contact CVTA and make arrangements to cancel or modify the charges.

Please enter the numbers you see in
the box to verify that you are not a spammer.(*)
Please enter the <strong>numbers</strong> you see in<br> the box to verify that you are not a spammer.
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