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VICA Membership Payment & Information Form

VICA uses this information for communication and planning purposes only. Contact information is never shared outside of VICA.

Please provide as much information as possible so that we may develop programs that are of interest to you. Enter your membership information first and then complete the remainder of the form.

Click on the "Enter Payment Information and Submit Form" button at the end to send the form and then enter your payment information. You can use any major credit card or PayPal

Thank you!


 

Payments & Contributions
Please select your type of membership. You can also contribute to VICA's Scholarship and Grants Fund, if you desire. Or you can contribute to VICA without becoming a member. All major credit cards and PayPal accepted.
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Member Contact Information
(If a business membership, please enter your business name in the Address Line 2 field.)
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Prefix
First Name
Last Name
Suffix
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Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country
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If different from primary number

Alternate contact number

Person in same household to receive VICA news about upcoming events


Share with us your interests in Italian Culture
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Get Involved!
VICA can always use volunteers because we have no paid staff! Tell us how you'd like to get involved with VICA.
Get involved with VICA
How Did You Learn About VICA
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Check all that apply