Online Membership Application

  • 2019 Membership

    Please fill out this form for renewals, new members and membership changes and send the form to the Treasurer:
    Doug Della Pietra, M.Div., CPXP
    Manager, Volunteer & Guest Services
    Rochester General Hospital
    1425 Portland Ave.
    Rochester, NY 14621
    585-922-4328 (office)
    Douglas.DellaPietra@RochesterRegional.org

    *Plus online registration service fee
  • $0.00
  • Once membership dues are received the member’s information on this form will be officially add/change/delete on our mailing list. The information will then be updated on our web page: www.nysavsa.org at which time active members will have full access to NYSAVSA and its services.

    Any questions please contact:

    Doug Della Pietra:
    585-922-4328
    Douglas.DellaPietra@RochesterRegional.org