Conference Registration

Note: You will receive an email confirmation in one - two weeks.

CAPTIVE CASH: If you are paying with Captive Cash, you must mail the Captive Cash to VCIA with your registration form and payment.

STEP 2: Enter Your Information

First Name* Middle Initial Last Name* Nickname for badge*

Title*

Captives: Please enter name of Captive Insurance Company in the Company field below, not parent company.

Company* Industry Type (Captives only) Domicile Mailing Address 1* Address 2 City* State/Province* Zip Code* Country* Direct phone and extension* Fax Email* Are you a first-time conference attendee?

CPE and CLE credits are available to those who participate in conference seminars. Participants are required to sign in to each seminar to be eligible for credit. To view general information on VCIA as a NASBA sponsor, please click here

How did you learn of this event? Do you wish to be listed on the conference attendee list (emails will not be released) If you have any special needs, please enter them here, or contact the VCIA at 802.658.8242.

Note: If you wish to attend the Art Studio Tour and Luncheon, please add $60 to the payment you will enter below.

Payment Options Payment Options: Payment Amount Credit card type Credit Card Number Expiration Month Expiration Year Name as it appears on card

Annual Conference

Conference Registration

Note: You will receive an email confirmation in one - two weeks.

STEP 2: Enter Your Information