Unit Membership

Complete the form below to tell us about your unit.

Important: The registration process consists of five sections: basic unit information, activity report (used to determine your annual dues), member registration, vehicle list, and special equipment list. Please complete all required sections. Once your registration is complete and your Unit account has been activated by the VAVRS Main Office, you will be able to update and add additional information your agency profile.

Agency Account Name:*

This is the login name for your agency. It is recommended that you use the acronym for your agency, i.e. BVRS, CVRS, etc., or the organization name without spaces, i.e. BlacksburgRescue, ChristiansburgRescue.

Important: Make sure you keep a record of the Agency Account Name that you create as it will be used to manage all of the accounts for your members.

Name of Squad/Agency:*

EMS Agency #:

District:*

Physical Address:

City	State	Postal Code
Street

Mailing Address:

City	State	Postal Code
Street

Mailing Contact:

County/City Squad is Located In:

Telephone:

Fax:

Email:

Website:

Date your unit voted to join VAVRS:

Do you bill for services?

How are your calls dispatched?

Does your unit render 24-hour - 365/366 days a year service?

Reason for Joining:

I certify to the best of my knowledge and belief, the above information is true and correct and that our squad voted to accept the rules and regulations of the VAVRS in force at this time.

Password:*

Confirm Password:**

Please ignore this field.

* indicates required fields.

Cancel Next