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CAPITAL CITY SYMPOSIUM

CAPITAL CITY SYMPOSIUM

March 11, 2023

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REGISTER NOW FOR CAPITAL CITY SYMPOSIUM!! MARCH 18TH IN RICHMOND VA!! 6 CEUS AVAILABLE, VENDORS, FOOD AND LOTS OF FUN! YOU DON’T WANT TO MISS THIS!

Virtual Symposium Registration

1Personal Information

2Payment Information

Personal Information
AARC Number
Name*
First Last
Credentials*
- CRT
- RRT
- NPS
- ACCS
- SDS
- RPFT
- CPFT
- RPSGT
- MD
- DO
- RN
- Student
- Other
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Enter Email Confirm Email
Employment Information
Facility / School
Job Function
Job setting
VSRC Board Position
- President
- President-Elect
- Past President
- Vice President
- Secretary
- Treasurer
- Delegate
- Blue Ridge District Director
- Central District Director
- Tidewater District Director
- Northern District Director
- Western District Director
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Do you require any special accommodations or dietary restrictions?*
- No
- Yes
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Special Accommodations
Please identify special accommodations.

Registration
Registration*
If only registering for 1 day, please specify what day.
Discount Code

Board member, event staff or speakers may enter their discount code.
Total
$0.00
Payment method
Credit Card
Card Details
Cardholder Name
Email
This field is for validation purposes and should be left unchanged.

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