jRetreat REGISTRATION FORM

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Register our annual jRetreat to be held January 13 in Petersburg, VA. Registration is $35 for JEA members and $50 for non-members. Information regarding available hotels and the schedule for the weekend will be available on www.vajta.org.

Email *

Last Name *

First Name *

School Name *

cell phone number *

(xxx) xxx-xxxx

Check all media that you advise *

newspaper

yearbook

online

broadcasting

literary magazine

Other:

Required

Are you a VAJTA member? *

Your registration will be complete when your check made payable to VAJTA arrives at 501 N. Armistead Street, #102, Alexandria, VA 22312. The registration fee ONLY covers the workshop itself. Participants are responsible for covering the cost of meals and lodging.

Yes - $25 registration fee

No - $35 registration fee

Will you be joining us for dinner on Friday night at Maria’s Restaurant in Olde Towne Petersburg at 7p.m.?

Yes

Clear selection

Will you be joining us for dinner on Saturday night at Trapezium Brewing at 6 p.m.?

Yes

Clear selection

Will you be joining us for social hour at Chris Waugaman’s house on Saturday night (after dinner)?

Yes

Clear selection

Will you be attending the board meeting at Demo Coffee Sunday morning at 9am?

Yes

Clear selection

A copy of your responses will be emailed to the address you provided.

Submit

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