RSVA ®

Randolph-Sheppard
Vendors of America®


Blind Businessmen and Businesswomen
Building a Better America

Member of
American Council of the Blind, Together for a bright future

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SAGEBRUSH


RSVA®

RESOURCES

 



The RSVA® 2021 SAGEBRUSH
CONFERENCE REGISTRATION FORM

Name:
Mailing Address:
City:
State:
Zip:
Home Phone:
Work Phone:
Cell Phone:
E-mail:

Are you a First Time participant? Please select Yes or No. YES No

Select if you do wish to share or not share your contact information with other participants, exhibitors and sponsors. Do Share Do NOT Share   
"Do Share" is the default
Check all boxes that apply if you are: a Vendor a Spouse a Guest
Speaker BEP-Staff Administrator Other
Check if you prefer Media Format: Large Print Braille CD Email
Please read the RSVA® Code of Conduct.
Check here to verify I have read and understand the RSVA® Code of Conduct Policy

Standard Registration

Early Registration Fee is $35 online.
Registration Fee after January 1, 2021, is $50 online.
Today is 10/21/2020 Registration Amount Today is $35
Other events and items not covered in registration fee.
Become Lifetime Member, $200  $200  
Become RSVA® member and receive Vendorscope: $10.00  $10  
RSVA® 50th Anniversary T-Shirt: $15.00 Click Checkbox if Yes, $15
Quantity
Sizes (S M L XL XXL)
$15 x Quantity
RSVA® 50th Anniversary Polo Shirt: $25.00 Click Checkbox if Yes, $25
Quantity
Sizes (S M L XL XXL)
$25 x Quantity
Individual convention sponsorships: Bronze  $25
Silver $50
Gold $100
Platinum $250
$25
$50
$100
$250
Donation Amount: Enter amount as a whole number only;
No decimals and no dollar signs.

You may pay by credit card through PayPal.

NOTICE TO ALL PARTICIPANTS:
Registration is required to receive the Zoom info for full participation in the conference and to have access to door prizes.
Sorry, we are unable to give refunds after January 1, 2021

Registration Fee: Registration will not be complete without payment.

  

For further information, you may contact RSVA® Ardis Bazyn at (818) 238-9321
or e-mail: rsva@randolph-sheppard.org.



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Randolph Sheppard Vendors of America
940 Parc Helene Drive Marrero, LA 70072
Email: rsva@randolph-sheppard.org Website: www.randolph-sheppard.org