Virginia Cemetery Association

New Member Application

Membership Application and Dues

Printable form if you prefer to mail in your Dues.

NEW MEMBER APPLICATION FORM

Virginia Cemetery Association Membership Application

Date:
Cemetery/Company Name:
Address 1:
Address 2:
City, State, Zip Code:
Telephone:
Fax:
Email:
Individual's Name:
Name of Parent Company (if Corporate Member):

How would you like to be contacted in the future? (Check One):

By Phone

By Email

Membership Type Details:

Active (Each Cemetery entitled to designate one member, with voting privileges). Membership is made up of two parts. Part 1. $200.00 per cemetery. Part 2. $1.50 assessment per burial for the Legislative and Consumer Protection Committee per year.
Part 1. $200. + Part 2. yearly burials _______ = Total

Associate (Each cemetery may have one or more with no voting privileges)...........................$100.00

Allied (Trade Supplier) (No voting privileges).................................................................................$200.00

Professional (Administration, Management Grounds, Sales, with no voting privileges).....$ 25.00

Which level of membership would you like? (Check One):

Active

Associate

Allied

Professional

Become A Member Of VCA