Online Registration Form Test

To become a member of VCOM complete the information below, then go to the payment page. Use your credit card with Pay Pal or mail you check to VCOM 1509 W. Cary Street, Richmond, VA 23220.

Membership – You receive a VCOM pin, patch, bumper sticker and yearly membership card

Supporter – Supporting law firms and attorneys will have their firm name displayed on the VCOM website.

Would you like to renew your membership in VCOM every year, by setting up annual recurring payments* or make a one- time extra contribution to VCOM?

* Annual recurring payments can be cancelled at any time.

Membership Form - One-Time Contribution Test

Name*
First Last
Address*
Street Address City State ZIP Code
Phone
Email*
Occupation*
Employer*

*Required for donations over $100
Club Memberships
Type of Motorcycles Owned
Are you a Registered Voter?
- Yes
- No
District - House
District - Senate
What issues are you most interested in seeing VCOM address?
Donation Amount*
Additional Amount
Amount
Total
$0.00
Business Name
Business Address
Street Address Address Line 2 City State ZIP Code
Business Phone
Business Website
Payment Method

MasterCard
Visa
Supported Credit Cards: MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name

Membership Form - Recurring Payments Test

Name*
First Last
Address*
Street Address City State ZIP Code
Phone
Email*
Occupation*
Employer*

*Required for donations over $100
Club Memberships
Type of Motorcycles Owned
Are you a Registered Voter?
- Yes
- No
District - House
District - Senate
What issues are you most interested in seeing VCOM address?
Donation Amount*
Amount

per year
Additional Amount

per year
Total
$0.00
Business Name
Business Address
Street Address Address Line 2 City State ZIP Code
Business Phone
Business Website
Payment Method

MasterCard
Visa
Supported Credit Cards: MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name