2018 VRIAC Registration Form

The deadline to register for VRIAC 2018 is midnight, Saturday, March 10th, 2018. The registration fee is non-refundable.
For lodging arrangements, please, contact DoubleTree by Hilton, Norfolk Airport, 1500 N. Military Hwy., Norfolk, VA.
Phone: 844-277-8642
After registration, your receipt and other related information will be mailed to the email address you provided in the form below.
For any information about your registration, email us at: SaintLeoVAConference@saintleo.edu

Type of Participation Saint Leo University Faculty Saint Leo University Student Other
Last Name
First Name
Street Address

City
Zip Code
State

Other:

Country
E-mail Address
Phone Number(s)Cell Phone:

Home Phone:

Emergency ContactFull Name:

Phone Number:

Institution/CompanyName:

Full Address:

Position/Title:

Do you intend to submit a proposal to present at the conference? Yes No
Registration FeeSaint Leo University Faculty ($75.00) Saint Leo University Student ($25.00) Other ($125.00)