: VML

Membership
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Membership

Membership Dues

Membership Name	Amount
Community Business Member - Bronze	$1000.00
Community Business Member - Silver	$2500.00
Community Business Member - Gold	$5000.00
Community Business Member - Diamond	$10000.00

Organization Contact Information

Address

Address Cont.

City

State

Zip Code

Country

Phone Number

VML Membership Contact

Username

Password

Confirm Password

Add Yourself as Primary Contact

First Name

Last Name

Job Title

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Mailing Address

Mailing Address Cont.

City

State/Province

Zip/Postal Code

Country

Work Phone

Work Extension

Email Address

Public Point of Contact

Username

Password

Confirm Password

First Name

Last Name

Job Title

Copy contact address from your Organization Contact Information

Mailing Address

Mailing Address Cont.

City

State/Province

Zip/Postal Code

Country

Work Phone

Work Extension

Email Address

Totals

Membership Dues:	$0.00
Discounts:	$0.00
Optional Subscriptions:	$0.00
Optional Donations:	$0.00
Optional Products:	$0.00
Taxes	$0.00
Credit Card Surcharge	$0.00
Total Payment:	$0.00

Payment Options

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Accepted Card Types

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Expiration Date

Expiration Year

CCV

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Billing Information

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Last Name

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Terms and Conditions By submitting this form you are authorizing your credit card to be charged for the indicated amount. There are no refunds available. Please see our full terms and conditions page for further details. If you have any questions, please contact Robert B. Bullington at rbullington@vml.org or call (804) 649-8471. Thank you for choosing Virginia Municipal League (VML).

Community Business Membership Application

Membership

Organization Basic Information

Organization Contact Information

VML Membership Contact

Public Point of Contact

Totals

There is a surcharge on credit card transactions to cover merchant fees.

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