VASM Exhibit Name Badges and Power Form 2026

2026 Annual Meeting | Extra Name Badges & Electrical Access Form

Hilton Richmond Hotel & Spa @ Short Pump | Richmond, VA | November 12 & 13, 2026
Please use this form to purchase extra name badges and electrical access at the Hilton Hotel
Company Information
Company Name
Contact Full Name
Contact Email
example@example.com
Payment Information
Payment Type
Credit Card Payment

If paying via credit card, make your selection below, provide credit card information, and click Submit. An email confirmation will be sent. If you have any questions, contact Charis Deadwyler at VASM@ramdocs.org or 804-393-3933.
Check / ACH Payment
If paying via check or ACH transfer:

1. Make your selection below

2. Use coupon code: PAYBYCHECK at the bottom of the product list to bypass the payment system

3. Click Submit.

The listed prices below include the credit card processing fees. Please refer to the exhibitor prospectus for pay by check prices. After submission we will send you an invoice for the correct amount.

An email confirmation will be sent to confirm receipt of application. If you would like to pay by ACH, contact Charis Deadwyler at VASM@ramdocs.or. Check payments should not include the convenience fee listed for online payment.

Additional Rep Badge

Additional badges over the quantity included in your level of support

$200.00 Quantity

Electrical Access at the Hilton

$25.00

Enter coupon

Total

On-Site Contact Information

Please review the prospectus for the number of registrations in each support level. Additional name badges can be purchased if you require additional representatives on site.
Additional Rep 1

First NameLast Name
Additional Rep email 1
example@example.com
Additional Rep 2

First NameLast Name
Additional Rep email 2
example@example.com
Additional Rep 3

First NameLast Name
Additional Rep email 3
example@example.com
Additional Rep 4

First NameLast Name
Additional Rep email 4
example@example.com
Check Payment: Make check(s) payable to: VASM

Payment must be received within 30 days of form submission.

Do not include convenience fee if paying by check. We will send you an invoice for the correct amount.

Send payment to:

VASM
Attn: Charis Deadwyler
2821 Emerywood Parway, Ste. 200
Richmond, VA 23294

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

2026 Annual Meeting | Extra Name Badges & Electrical Access Form