Posted on April 4, 2023 - April 4, 2023 by cguske AIA Virginia > Form > Art of Practice Registration 2023 - Art of Practice "*" indicates required fields Name* First Last Member NumberPlease enter your AIA member number if you wish to have credit reported to your transcript. Designation(AIA, Assoc. AIA, FAIA) Phone*Email* Firm/Organization Name Firm Size*Please select the size that best describes your firm or the cohort of leaders with whom you'd most like to connect. Large Firm (25+ employees) Mid-Sized Firm (10-24 employees) Small Firm (1-9 employees) Demographic Information (optional)AIA Virginia is working proactively toward equity and inclusivity in our programming. In an effort to help assess how well we're serving members, we've developed standard demographic questions below. The following questions are completely optional and data will not be reported in a way that allows an individual respondent's identity to be known or tied to their responses.Age range:(optional) 20-29 30-39 40-49 50-59 60-69 70-79 80 or more I identify my ethnicity as:(optional) Press control to select more than one.AsianBlack/African AmericanCaucasianHispanic/Latina/LatinoAmerican Indian/Alaska NativePacific Islander/Native HawaiianOtherI identify my gender as:(optional) Male Female Nonbinary (neither, both, or something else) I identify my sexual orientation as:(optional) Heterosexual/straight Gay/lesbian Bisexual/pansexual Something else Register* AIA ($165) Assoc. AIA ($125) Please select your AIA member status.Discount Code Total all ticket sales are final. No refunds will be issued.Please list any dietary restrictions. Credit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20232024202520262027202820292030203120322033203420352036203720382039204020412042 Security Code Cardholder Name Billing Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code CommentsThis field is for validation purposes and should be left unchanged.
