Association of Zoo Veterinary Technicians

MEMBERSHIP APPLICATION

Renewal membership fees are due between October 1 and January 31 of each calendar year. There’s a $5.00 late fee for renewals after January 31
( includes past/returning members ). Late fee is for renewals only.
Dues: Active/Associate = $35; Subscribing (includes students) = $17; Institutional = $60

Membership Type:
Membership Category:	Click for Membership Categories
Credentialing:

Member Name:
Work Address: (This will be used in the Membership Directory unless you specify otherwise.)
Institution Name:
Address:
City: State: Zip/PostCode:
Phone Number: ext: FAX Number:
Email Address:

Home Address: (Not required if you use your work address for mailings.
If no employer is listed, this will be listed in the Membership Directory unless you specify otherwise.)
Address:
City: State: Zip/PostCode:
Phone Number: ext: FAX Number:
Email Address:

Degree Earned: Certification Number:

Job Title: Number of Years:
Supervisor’s Name (for employee verification):
Briefly List Duties:
How did you learn about AZVT:


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