Event Registration Form Demo

Name*
First Last
Company / Firm Name
Address*
Street Address Address Line 2 City State ZIP Code
Daytime Phone*
Email*
Membership Discount
Are you a VLA Member trying to register for this class? E-mail or call VLA to get your membership discount code and enter it here! - registrations@vlany.org or 212.319.2787 x 10
Select Ticket / Membership Status*
- Full-Time Student - $20
- Artists Over Sixty - $20
- Arts Professional - $40
- Legal Professional - $70
- Young Associate Members (YAM’s) and Associate Board Members - $50
Student ID
Students must present proof of full-time status with registration -- please upload a snapshot here.
Accepted file types: jpg, png, gif, jpeg, pdf.
Quantity
Please indicate if you would like to register multiple attendees.
Please enter a number from 1 to 12.
Total
$0.00
Credit Card

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
Please click "Register" just once to process your secure online transaction. You will receive a confirmation message when it is complete.
Comments
This field is for validation purposes and should be left unchanged.