Order Form

  Please select the items you wish to order and enter the quantity, then press "Checkout".
Please select the appropriate items you wish billed to your credit card, and
click "Checkout" when you are ready to enter your billing information.
Thank you.
Stock # Description Amount Qty
Annual Golf Tournament Sponsorship Base Price Qty
Golf-Gold
Gold Sponsor
Gold Sponsorship - Golf Tournament
$
Golf-Silver
Silver Sponsor
Silver Sponsorship - Golf Tournament
$
Golf-Bronze
Bronze Sponsorshuip
Bronze Sponsorship - Golf Tournament
$
Golf-Team
Team of 4 Players
Team of 4 Players - Golf Tournament
$
Golf-Individual
Individual Player
Individual Player - Golf Tournament
$
Annual Meeting Registration Fees Base Price Qty
member-pre
NOVA Member - before 2/20/09
NOVA Member registering before 2/20/09
$
member
NOVA Member - after 2/20/09
NOVA Member registering after 2/20/09
$
nonmember
Non-Member Registration
Non-Member Registration
$
guest
Spouse/Guest (Non-VA Employee)
Registration Fee for Spouse or Guest (Non-VA Employee)
$
retiree
NOVA Retiree Registration
NOVA Retiree Registration
$
daily
Daily Attendance Fee
Daily Attendance Fee (CEU's not included)
$
event1
NOVA Foundation Reception & Auction
NOVA Foundation Reception & Auction (per person).
$
event2
Habitat for Humanity Optional Event
Habitat for Humanity Optional Event (per person).
$
Annual Membership Fees Base Price Qty
active
Active Membership
Annual Membership Fee - Active Member
$
retired
Retired Membership
Annual Membership Fee - Retired Member
$
legacy
Legacy Membership
5-Year Membership for Retired VA Nurses
$
pin
NOVA Pin
NOVA Pin
$
Make a NOVA Foundation Donation Base Price Qty
D10
$10 Donation
I would like to donate $10 to the NOVA Foundation.
 
Donate To: :
 
$
D25
$25 Donation
I would like to donate $25 to the NOVA Foundation.
 
Donate To: :
 
$
D50
$50 Donation
I would like to donate $50 to the NOVA Foundation.
 
Donate To: :
 
$
D100
$100 Donation
I would like to donate $100 to the NOVA Foundation.
 
Donate To: :
 
$
D250
$250 Donation
I would like to donate $250 to the NOVA Foundation.
 
Donate To: :
 
$
NOVA Foundation Merchandise Base Price Qty
CS-1
Cool Scarves for Soldiers - Sponsorship Donation
Cool Scarves for Soldiers - Sponsorship Donation
 
Name :
 
 
RN or Supporter :
 
$
CS-2
Cool Scarves for Soldiers (Package of 2)
Cool Scarves for Soldiers (Package of 2)
 
Name :
 
 
RN or Supporter :
 
$
DB-1
Duffel Bag
NOVA Foundation Duffel Bag
$
FS-1
NOVA Foundation Fleece Sweatshirt
NOVA Foundation Fleece Sweatshirt
 
Size :
 
$
NFB-1
NOVA Foundation Blanket
NOVA Foundation Blanket
$
BS-1
NOVA Bumper Sticker
Bumper Sticker (1)
$
BS-10
NOVA Bumper Sticker (Pkg 10)
Bumper Stickers (10 Pack)
$
novahistory
The History of NOVA
The History of NOVA 48-Pg Book
$
pin
NOVA Pin
NOVA Pin
$
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For more information:
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1726 M Street, NW, Suite 1101
Washington, DC 20036 US
202-296-0888
Fax: 202-833-1577

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