Sign Up

NOTE: This form is for registering a non-member account. To enjoy full member benefits, you can upgrade your non-member account to an individual membership by calling 1-800-833-0602.

If you are a member of a VAVRS member squad or agency, please contact your squad administrator to create an account for you. This will ensure that you get your proper squad member benefits.

If your squad is interested in a unit membership you may apply online, or visit the Join VAVRS for more information.

District:

First Name:*

Middle Name:

Last Name*

Suffix:

SSN (Last 4):

Birth Date:*

Email:*

Work Phone:

Home Phone:

Cell Phone:*

Pager:

Address:*

City	State	Postal Code
Street

VAVRS Honors:

Honors:

Life Member

Hall of Fame

Past President

Current VAVRS President

Current VAVRS Vice President

Current VAVRS Secretary

Current VAVRS Treasurer

Password:*

Confirm Password:**

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