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Maryland
Veterinary
Medical
Association FIND AN MVMA VETERINARIAN Doctor's Name Practice Name City State (use two character abbreviation such as MD) Zip Code SEARCH THE MVMA WEB SITE Search our site with Enter your search terms Web mdvma.org MVMA RVT Membership Application Please complete the following form and click the submit button to apply for membership in the Maryland Veterinary Medical Association. This application must be accompanied by the full membership dues for the first year. To download a printable application to return by fax or U.S. Mail, click here. Registered Veterinary Technician Membership Dues $25/year The Registered Veterinary Technician membership shall consist of Registered Veterinary Technicians (RVT) who have been recommended by a regular member of MVMA. Registered Veterinary Technician members may not vote or hold office. First Name MI Last Name Position/Title Employer Office Address City State Zip County Allegany County Anne Arundel County Baltimore City Baltimore County Calvert County Caroline County Carroll County Cecil County Charles County Dorchester County Frederick County Garrett County Harford County Howard County Kent County Montgomery County Prince George's County Queen Anne's County St. Mary's County Somerset County Talbot County Washington County Wicomico County Worcester County Home Address City State Zip Which address do you wish to appear in the directory? Home Office Office Phone Home Phone Fax Mobile Phone Business E-mail Personal E-mail Veterinary Technician School Year Degree Date of Birth City State Marital Status Single Married Spouse's Name RVT Sponsor MVMA Member's Name Practice Name I hereby apply for membership in the Maryland Veterinary Medical Association. If accepted into membership, I certify that I will abide by the MVMA Constitution, Bylaws and Principles of Veterinary Medical Ethics. I understand my credit card will not be charged if my application is not accepted. MVMA estimates that 12 percent of your membership dues are not deductible because of MVMA's lobbying activities on behalf of its members. Your membership dues may be deductible as an ordinary and necessary business expense, but are not deductible as a charitable contribution. PAYMENT INFORMATION Please charge $ to my: VISA MasterCard American Express Card Number Exp. Date CSC # What's this? Cardholder name Billing Address City State Zip MVMA Privacy Notice l MVMA Security Policy l MVMA Return Policy © 2011 Maryland Veterinary Medical Association Maryland Veterinary Medical Association l 3230 Maiden Lane l Suite 5 l Manchester, MD 21102 l phone: 443-507-6500 l fax: 443-507-6519 e-mail: mvma@managementalliance.com
FIND AN MVMA VETERINARIAN
Doctor's Name Practice Name City State (use two character abbreviation such as MD) Zip Code
Practice Name
City
State (use two character abbreviation such as MD)
Zip Code
SEARCH THE MVMA WEB SITE
Enter your search terms
Please complete the following form and click the submit button to apply for membership in the Maryland Veterinary Medical Association. This application must be accompanied by the full membership dues for the first year.
To download a printable application to return by fax or U.S. Mail, click here.
Registered Veterinary Technician Membership Dues
$25/year
The Registered Veterinary Technician membership shall consist of Registered Veterinary Technicians (RVT) who have been recommended by a regular member of MVMA. Registered Veterinary Technician members may not vote or hold office.
First Name MI Last Name
Position/Title
Employer
Office Address
City State Zip
County Allegany County Anne Arundel County Baltimore City Baltimore County Calvert County Caroline County Carroll County Cecil County Charles County Dorchester County Frederick County Garrett County Harford County Howard County Kent County Montgomery County Prince George's County Queen Anne's County St. Mary's County Somerset County Talbot County Washington County Wicomico County Worcester County
Home Address
Which address do you wish to appear in the directory?
Home Office
Office Phone Home Phone
Fax Mobile Phone
Business E-mail
Personal E-mail
Veterinary Technician School Year
Degree
Date of Birth City State
Marital Status Single Married Spouse's Name
RVT Sponsor
MVMA Member's Name
I hereby apply for membership in the Maryland Veterinary Medical Association. If accepted into membership, I certify that I will abide by the MVMA Constitution, Bylaws and Principles of Veterinary Medical Ethics. I understand my credit card will not be charged if my application is not accepted.
MVMA estimates that 12 percent of your membership dues are not deductible because of MVMA's lobbying activities on behalf of its members. Your membership dues may be deductible as an ordinary and necessary business expense, but are not deductible as a charitable contribution.
PAYMENT INFORMATION
Please charge $ to my:
VISA MasterCard American Express
Card Number Exp. Date CSC # What's this?
Cardholder name
Billing Address
State Zip
MVMA Privacy Notice l MVMA Security Policy l MVMA Return Policy
© 2011 Maryland Veterinary Medical Association
Maryland Veterinary Medical Association l 3230 Maiden Lane l Suite 5 l Manchester, MD 21102 l phone: 443-507-6500 l fax: 443-507-6519
e-mail: mvma@managementalliance.com
