Who Can Join?

Annual Membership Dues

Active Members: $35 / Technicians, assistants, office managers, front office staff, kennel staff employed by an AzVMA-member hospital

Non-AzVMA Active Members: $45 / Same as active members, but not employed by an AzVMA-member hospital

Associate Members: $55 / Allied industry members, veterinarians, educators

Student Members: $20 / Individuals currently enrolled in an accredited veterinary technician/assistant program

r Yes! Enroll me in the Veterinary Health Care Team of Arizona as an:

r Active Member          r  Non-AzVMA Active Member                                   r Associate Member
r Student (If a student, please provide name of college)____________________________________

I am a:
r Technician (CVT, LVT)     r Front Office Staff     r Veterinarian    r  Assistant
r Kennel Staff                  r Educator                r Manager         r Allied Representative
r Other

I work with:   r Small Animals     r Large Animals      r Exotics       r Wildlife       r Zoo

r I am licensed:  State___________________License #____________________________________

r I am interested in serving as a committee/board volunteer.

Name:__________________________________________________________________________________________

Hospital/Clinic:___________________________________________________________________________________

Bus. Address:____________________________________________________________________________________

City/State/Zip:____________________________________________________________________________________

Phone:  ________________________________________  Fax:____________________________________________

E-mail:  _________________________________________________________________________________________

Home Address___________________________________________________________________________________

City / State / Zip:_________________________________  Home Phone:__________________________________