Virginia FFA Day at the Capitol
Registration is limited to schools and students that participated in an Ag Leaders Conference in November. This form is due by 5 p.m. on December 19th. Corrections can be made until January 7th.
Attendee Information
Chapter/School Name
*
Chapter Number
*
Advisor #1
*
First Name
Last Name
Advisor #1 Email
*
example@example.com
Advisor #1 Cell Phone
*
Please enter a valid phone number.
Additional advisors/adults who will be attending (please use a bulleted list):
*
Students who will be attending (please use a bulleted list):
*
Please list dietary restrictions for any attendees (boxed lunch on 1/23)
*
Total individuals for lunch ($12 a person)
*
Name of student that will represent your chapter in the Senate or House Gallery
*
First Name
Last Name
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Housing Needs
$185/night per room. Please fill out additional forms if there are not enough rooms below.
We will be using the Virginia FFA housing block:
*
Yes, we will arrive on the evening of the 22nd.
No, we will travel on the morning of the 23rd.
Room One (max 4 occupants):
Splitting this room with (name of school):
Leave blank if room is for your school only.
Room Two (max 4 occupants):
Splitting this room with (name of school):
Leave blank if room is for your school only.
Room Three (max 4 occupants):
Splitting this room with (name of school):
Leave blank if room is for your school only.
Room Four (max 4 occupants):
Splitting this room with (name of school):
Leave blank if room is for your school only.
Room Five (max 4 occupants):
Splitting this room with (name of school):
Leave blank if room is for your school only.
Submit
Should be Empty: