PAY RENEWAL

Licensed Veterinary Technician: $60/year

MEMBER INFO

Prefix *

First Name *

Last Name *

Suffix

Email *

This MUST be the email that is uniquely associated with this member. It is the same email address that is used to log into the membership area.

HOME CONTACT INFO

Street Address *

City *

State *

Postal code *

Mobile Phone

EDUCATION & EMPLOYMENT

Credentials *

DVM

VMD

LVT

CVT

CVPM

Other Credentials, Specify

County of Practice *

Kent
New Castle
Sussex
Outside DE
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Veterinary Technology School *

Year of Graduation *

License Number *

Current Employer *If none, enter n/a

Employer Street Address *

Employer City *

Employer State *

Employer Zip Code *

Employer Phone

Practice Area *

Academic

Avian

Equine

Emergency

Exotics

Food Animal

Government

House Calls

Kennel

Laboratory

Large Animal/Production

Military

Mixed

Mobile

Private Industry

Regulatory

Small Animal

Other

Surgery

Volunteer Interests

Awards Committee

County Representative (Executive Board)

Executive Board/Officer

Diversity, Equity & Inclusion Committee

Government Relations Committee

Scholarship Review Committee

Veterinary Technology Committee

AMOUNT DUE: Click on amount to approve, turns blue when selected. *

$ 60

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