SCAVMA Membership Form

SCAVMA Membership Form - 2009-2010
^*Required information
Note: please make sure you have filled out all required information. The form will not yell at you if you miss something. Thank you!

If you have already bought a syllabus that is currently available through Curry Printing before registering for SCAVMA and would like reimbursement, please select that option from the drop-down menu. Please note that some syllabi will not be available through Curry Printing (or anywhere else) before the spring semester.

This year's gift is a printed syllabus!

Please select one:

Fourth year gift: gift card to the cafe (no selection required)

Third year choices:

Second year choices:

First year choices:

General Information
^*First Name
Middle Name
^*Last Name
Suffix
Maiden Name
^*Grad Year
Gender
Birthday (mm/dd/yy)
^*Phone
^*Email

Permanent Address
^*Permanent Address Line 1 (street)
Address Line 2
^*City
^*State
^*Zip
^*Country

Local Address
Same as permanent address Different from permanent address:
Local Address Line 1 (street)
Address Line 2
City
State
Zip

Journal Subscriptions (discounted with your SCAVMA membership)

Journal of the AVMA (JAVMA) $40.00
Subscribe? Yes No

American Journal of Veterinary Research (AJVR) $40.00
Subscribe? Yes No

Journal mailing address
If you have selected to receive journal(s), please select the address where you want your publications to be sent
Permanent Address Local Address

Committee Obligations
As a member of SCAVMA, you are required to participate on a committee for TWO YEARS to remain a member in good standing. Please indicate your committee preferences, or if you have already fulfilled this requirement please select none.

First choice: Second choice: Third choice:

SCAVMA membership

Early registration is now over, and prices have increased to reflect the increased member dues we must pay to National SAVMA. You may sign up for multiple years and get a discount. (This is the first year that multiple-year signup has been offered, so no one who registered last year is registered for multiple years.)

One year membership: $47.00
Two year membership: $84.00
Three year membership: $126.00
Four year membership: $163.00

Payment
If you are finished filling out this form, hit the "pay" button below to pay before you click the submit button. Follow the payment instructions on our secure online host. Then push the submit button at the bottom of this page. Important! Please remember to hit the submit button or else we will not receive your information, just your money.

This page will stay open to easily allow you to do both, so don't close this window until you've hit both "pay" and "submit information."

If you prefer to submit your information on a paper form, please contact Deborah Thomson V'12. If you are having technical difficulties, please contact Emily Clore V'12.