Registration forms for AzVMA continuing education programs

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Fax registration with credit card information to AzVMA 602.249.3828
or mail with check to: AzVMA, 100 W. Coolidge St., Phoenix, AZ 85013
Questions? Call AzVMA at 602.242.7936

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recent graduate / Tucson 
Wednesday, April 30, 2008
AzVMA Member: $20      Non-member: $45
2007 graduate Non-Member: $45 (includes 1-yr AzVMA membership)  

 Please indicate if you are a 2007 graduate.

 Please check if you require a vegetarian meal.

Payment Method:  * Visa    * MasterCard    * Check
Name:
Hospital:
Phone: Fax:
Visa or MC#: Exp. Date:                                                        Amount: 
V-code: (Last 3 digits of the number located on the back of the card near the signature box:
Credit card billing address zip code:
Credit card holder's name: Signature:

Registration requested by 4/23/08. See above for fax number or address.
 

Small animal Specialist meeting 
Thursday, May 8, 2008
AzVMA Member: $125      Non-member: $250
Non-Member: $383 (includes member rate for CE and 1-yr AzVMA membership with $26 initiation fee waived)

* Please check if you require a vegetarian meal.

Payment Method:  * Visa    * MasterCard    * Check
Name:
Hospital:
Phone: Fax:
Visa or MC#: Exp. Date:                                                        Amount: 
V-code: (Last 3 digits of the number located on the back of the card near the signature box:
Credit card billing address zip code:
Credit card holder's name: Signature:

Registration requested by 5/1/08. See above for fax number or address.