VCBG Membership Form

Virginia Craft Brewers Guild Membership Form

To join please complete the following information:
Type of membership:

Associate Member - $735 Brewery in planning - $50 0-1000 Barrels - $250 Over 1,000 Barrels
Enter last years # of barrels produced *
Company: *
Company Address: *

Mailing Address:

Street Address if different than above:

City State

Zip Code
Year Established in Virginia: *
Number of full time employees: *
Principal Products:
When are the best days/times to contact you?

Monday 8-12 AM 12-5 PM Tuesday 8-12 AM 12-5 PM Wednesday 8-12 AM 12-5 PM Thursday 8-12 AM 12-5 PM Friday 8-12 AM 12-5 PM
Principal/Owner: *
Title:
Phone : *
E-mail: *
Brewer Contact: *
Title:
Phone (including extension): *
E-mail: *
Marketing Contact:
Title:
Phone (including extension):
E-mail:
Financial/Accounting Contact:
Title:
Phone :
E-mail:
HR/Operations Contact:
Title:
Phone (including extension):
E-mail:
Quality/Safety Contact:
Title:
Phone (including extension):
E-mail:
Click below link to locate your VA Districts:

Virginia State Legislative Directory
VA Senate District:
VA House District:
U.S. Congressional District:
Please check the areas of interest for your company: *

Group Employee Benefits Business insurance: P&C, Workers comp, etc Quality & Safety Training Certification Program 401k Plan options Events Advocacy Other
Enter Payment Amount:
Investment calculation
Method of payment: *

Credit Card Invoice me

Enter Payment Amount

USD

Applicant's Full Name: *
Date:

Month Day Year
Investments paid to the Virginia Craft Brewers Guild are not deductible as a charitable contribution.

Effective January 1, 1994, Congress restricted the tax deductibility for certain lobbying costs. We estimate that 30% of your Investment is attributable to non-deductible lobbying costs, and 70% of your investment is deductible as an ordinary and necessary business expense.

FID #: 54-0452521
How did you hear about us? *
To submit, click the "Join now" button below. THANK YOU!!
Guild member Name and Brewery
Event Name
Social Media
Other
Should be Empty: