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JAVMA Membership/Registration Form - Renewal due June 1 annually
Please print form, fill out and return with a check
made out to JAVMA for annual dues:
$50 per veterinarian or $150 per hospital to:
Dr. Geri Carlson
100 Birch Way
Barboursville, VA 22923
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JAVMA Membership
June 1, 2013 - May 31, 2014 |
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Name |
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Hospital Name |
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Hospital Address |
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Hospital webpage |
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Special services you'd like listed on JAVMA webpage |
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Home Address |
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Phone (work) |
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Phone (home/cell) |
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Fax |
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Email (JAVMA primary contact) |
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OK to send email info about other CE events? |
Yes ___ No ___ |
Membership year runs June 1 - May 31
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