VTA Membership Registration Form

VTA Membership Registration

Complete the form below to register as a member of the Virginia Theatre Association.
Name

First NameLast Name
E-mail
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Organization (if applicable)
Birth Date

MonthDayYear
Which Division do you identify with?

SecondaryCollegeProfessionalTheatre for YouthCommunity TheatreTechnology & Design
Adult Membership is available to anyone 21 years of age or older.
My Products
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One Year MembershipOctober 2024 - October 2025
$50.00

Lifetime MembershipBecome a member of VTA for Life!
$500.00

Total

$0.00

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