Membership Application Form

Name*

First NameLast Name

Birth Date

MonthDayYear

Phone Number*

Format: (000) 000-0000.

Email*

example@example.com

Year of study*

Animal Care: Members are primarily focused on local volunteer opportunities, leadership opportunities, and agricultural experience.Pre-Veterinarian: Preparation for vet school includes hands-on animal experience, shadowing a veterinarian, meetings with vet schools, and networking with vet students.Both (Required for those interested in E-Board positions)

Please share why you would like to be a part of our organization?*

Emergency Contact Please list two (2) family members

Emergency Contact

2nd

Where are you from? (Home Town)

Please note: This is a non-profit organization. Membership fees help cover the cost of trips, fundraisers, events, and activities. Submit your fees to our cah app $PVAACasu if you have any trouble submitting payment.

Pre Vet Membership

travel donation included

$40.00 Quantity

Animal Care Membership

donation included

$40.00 Quantity

Dual Membership

Travel donation included

$45.00 Quantity

New membership

travel donation included

$50.00 Quantity

Total

$0.00

Payment Methods

Credit Card

Cash App Pay