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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


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 



Office Address

City    State    Zip    


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    


Date of Birth    City    State

Marital Status    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.


 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


2017 Maryland Veterinary Medical Association

Maryland Veterinary Medical Association l PO Box 5407 l Annapolis, MD 21403
phone: 410-268-1311 l fax: 410-268-1322

e-mail: MVMA@KeyAssnMgt.com