Company Information

Name of Company *
Street Address *
City *
State *
Zip Code *
Web Address
Number of Employees in L.A. County *
Year Founded *
How did you hear about VICA *
Twitter ID
Facebook ID
Description of your Company (25 words or less)

Primary Contact

First Name *
Last Name *
Title *
Phone # *
Fax #
E-mail Address *

 

 

Additional Contact(s)

First Name
Last Name
Title
Phone #
Fax #
E-mail Address
First Name
Last Name
Title
Phone #
Fax #
E-mail Address
First Name
Last Name
Title
Phone #
Fax #
E-mail Address

 

 

Payment

Membership level *

For membership levels above $5,000, call the VICA office at 818.817.0545 to discuss the best package for your business.

 

New Membership
Membership Renewal

Federal Tax ID # 23-7182039. 501(c)(4). Talk to your tax advisor about deducting your Valley Industry and Commerce Association (VICA) investment as a business expense. VICA estimates that for 2008, 25 percent of its budget is used for lobbying activities and therefore membership dues may not be tax deductible.

If you see this paragraph and the element below, then your browser doesn't properly support cascading style sheets. Do not change the values in the form elements below. They are used to prevent spam bots from using this form to send spam.

* Indicates a required field