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2014 Mid-Atlantic States Bovine Conference

16 Hours Continuing Education

Registration Form

Fill out the form below to register for the seminar. If you prefer to register by fax or mail, click here to download a form to print.

 

REGISTRATION FEES

Before 3/15

After 3/15

 

Veterinarians

$290 both days
$155 one day (March 27 or 28)

$325 both days
$185 one day (March 27 or 28)

 

Veterinary Technicians

$210 both days
$155 one day (March 27 or 28)

$235 both days
$170 one day (March 27 or 28)

 

Students of Veterinary Colleges

$190 both days
$125 one day (March 27 or 28)

$215 both days
$130 one day (March 27 or 28)

REGISTRATION SELECTIONS: (List all attendees)

First Registrant

Name Nickname           $

VMD   DVM   RVT Technician    Student     

Do you require a  vegetarian meal   kosher meal


Second Registrant

Name Nickname           $

VMD   DVM   RVT Technician    Student     

Do you require a  vegetarian meal   kosher meal


Third Registrant

Name Nickname           $

VMD   DVM   RVT Technician    Student     

Do you require a  vegetarian meal   kosher meal


 

                $


SPEAKER NOTES

Access to speaker notes online is included in your registration fee.

PAYMENT INFORMATION

Practice Name

Address 

City

   State     Zip

Work Phone

  Fax  

E-mail

 Please charge $  to my:

  VISA   MasterCard   American Express

Card Number Exp. Date   CSC # What's this?

Cardholder name

Billing Address

City

   State     Zip

 IMPORTANT: If you have a disability or dietary need and require special accommodation in order to fully participate in this event, please include a written description below. We can only provide access if we have prior notice.

       

NO REFUNDS AFTER MARCH 15, 2014

 

 

 

 


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2014 Maryland Veterinary Medical Association

Maryland Veterinary Medical Association l 3230 Maiden Lane l Suite 5 l Annapolis, MD 21403
phone: 410-268-1311 l fax: 410-268-1322

e-mail: MVMA@KeyAssnMgt.com