VIADC New Membership Application
Complete this form only if you are joining VIADC for the first time or are becoming a Lifetime member.
Renewing Members, please complete the Membership Renewal Form.
If you are a student, please complete the New Student Membership Application.
Email address *
Last Name *
Your answer
First Name *
Your answer
Birth Month *
New Membership Type *
Required
T-Shirt Size *
Home Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Mobile Number *
Your answer
Application Submission Date *
MM
/
DD
/
YYYY
Your Profession or Business (Check all that apply)
THANK YOU!
Annual dues are valid for 12-months, renewable annually on January 1 (annual membership period is January 1 to December 31). Membership dues may be safely and securely paid at the VIADC website www.viadc.org under the 'Join VIADC' tab, OR a check/money order may be made payable and mailed with the completed application form to Virgin Islands Association,1629 K St, NW, Ste. 300, Washington, DC 20006.
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