Student Award Membership Application
Name
*
First Name
Last Name
Designation
*
Ex.: DVM
Current Practice/Institution
*
Business Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Business Phone
*
Include country code for international numbers.
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Personal Phone
*
Include country code for international numbers.
Preferred Mailing Address
*
Business
Home
Email
*
Ensure you are able to keep your school email post graduation if entering here
Veterinary School
*
Graduation Year
*
Are you enrolling in a residency program? AAVD offers free membership to Residents after your Student Award membership expires!
Yes, continue my membership when my current membership expires!
No, though I may become a member after my student award membership expires
Anticipated residency completion year:
*
Please upload your current CV
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I understand by becoming a member of AAVD I am granting permission to AAVD to send emails to the contact email associated with my membership
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Exclude my information in the Member Directory
*
Yes, exclude it
No, I allow it
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