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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
 

 

JAVMA Membership

June 1, 2013 - May 31, 2014

Name 
 
Hospital Name 
 
Hospital Address 
 
Hospital webpage
 
Special services you'd like listed on JAVMA webpage
 
Home Address 
 
Phone (work) 
 
Phone (home/cell)  
 
Fax 
 
Email (JAVMA primary contact) 
 
OK to send email info about other CE events?
Yes ___     No ___

 

Membership year runs June 1 - May 31

 
 
 
 
 
 
 
 
 

Jefferson Area Veterinary Medical Association
505 St. Francis Avenue
Earlysville, VA 22936
grussvet@gmail.com
(434)973-9699