2024 VMCA Membership Form

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- If you register for the 2024 VMCA Conference, VMCA membership is complimentary and this form is not needed

- If you do not plan to attend the 2024 VMCA conference, please continue with this form
- Contact us at (757) 514-7608 or VirginiaMosquito@gmail.com

Email *

Last Name *

First Name *

Organization or Affiliation *

Mailing Address (Number, Street, City, State, Zip) *

Phone Number *

Membership type:

- All memberships include access to the VMCA newsletter, can serve on committees, and can attend board meetings and the annual business meeting.

- Only regular members can hold office and have voting privileges

Regular Membership - $20

Associate Membership - $15

Student Membership (proof of enrollment required upon request) - $10

I understand that payment is due for this membership.

Upon submitting this form, you will be directed to a payment link to pay via PayPal (or credit card). If you prefer to pay via cash or check, you can close the webpage and you will be emailed an invoice with your order total. Cash or checks can be dropped off or mailed to: Jay Kiser, Suffolk Mosquito Control, 800 Carolina Rd. Suffolk, VA 23434. Checks should be made out to Virginia Mosquito Control Association.

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