2011 FCCLA VIRGINIA ASSOCIATION REGISTRATION FORM
Conference Dates: July 9- July 15, 2011     Anaheim Marriott
Reservation form must be received by May 5 
Deposit is due by May 23    Payment in full is due by June 13
 
2011 RATES
Quad - $1,060 | Triple - $1,163 | Twin - $1,369 | Single - $1,987
 
You will receive a detailed confirmation with your exact amount due via the email address you provide below. 
Please mail your deposit check for $600 per person to our office NO LATER than May 23, 2011.
Please indicate the name of your school in the memo section of your check.
The balance is due NO LATER than June 13, 2011.

Click here to read cancellation policy and consumer disclosure notice

PLEASE NOTE: Reservation form cannot be saved before submitting so please be sure you have all necessary information before filling out form to avoid having to re-enter information.
Departure City  
* Please call Traveltyme for airline information
** Add $53 per person for departure from Tri-Cities
    Add $46 per person for departure from Richmond
    Add $41 per person for departure from Norfolk

Name: 
School Name:   
Street Address: 
City:    State:     Zip Code:
School Phone Number (with area code):      Ext:   
Contact E-Mail Address*:     
*Your reservation confirmation and invoice will be emailed to this address
Advisor Name: 
Home Address: 
City:    State:    Zip Code:
Cell Phone Number (with area code):     
Home Phone Number (with area code):     
Advisor E-Mail Address*:     
*A copy of your reservation confirmation and invoice will be emailed to this address
Airline Passenger Information
Please Note: First, Middle and Last name must match government issued photo ID. Required by the TSA

 
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Advisor / Adult Reservations
*If you would like to room with specific advisors from other schools please DO NOT enter their names in the reservation form blanks but enter their name and school in the "Room Comments" field below the reservation fields.
Adult Reservations Room 1* * Be sure to use full legal name
Name of Person #1
Name of Person #2
1st Room Size:
Adult Room 1 Comments:
Adult Reservations Room 2* * Be sure to use full legal name
Name of Person #1
Name of Person #2
2nd Room Size:
Adult Room 2 Comments:
Student Reservations
*If you would like to room with specific students from other schools please DO NOT enter their names in the reservation form blanks but enter their name and school in the "Room Comments" field below the reservation fields.  If you would like us to find roommates for you, please indicate that in the "Room Comments" field.  All efforts will be made to accommodate your request for locating roommates but we cannot guarantee this.
** If you need additional rooms, please fill out a second reservation form for the other rooms
1st Room Occupants* (Maximum of 4 to a room)
 
Name of Person #1
Name of Person #2
Name of Person #3
Name of Person #4
1st Room Size:
 
Room 1 Comments
2nd Room Occupants* (Maximum of 4 to a room)
 
Name of Person #1
Name of Person #2
Name of Person #3
Name of Person #4
2nd Room Size:
 
Room 2 Comments
 
Comments, Questions, Additional Information:
 		Reservation Totals:
Please confirm the number of people you are registering in each room type
# of People in Quads x $1,060
# of People in Triples x $1,163  
# of People in Doubles x $1,369
# of Person in Singles x $1,987

You will receive a reservation confirmation and invoice via email.