SCNAVTA Student Advisors Change Request Form

SCNAVTA Student Advisors Change Request Form

Form for SCNAVTA Chapters to update their student advisors. Advisors must be a graduate of an AVMA-accredited program and/or credentialed as a veterinary technician.
Just oneBoth
Advisor #1:
Full Name*

First NameLast Name
Credentials:*
Email Address:*
example@example.com
Home Address:*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Phone Number:*
Please enter a valid phone number.Format: (000) 000-0000.
Which program did you graduate from?*
Year of graduation:*
Have you previously been a NAVTA member?*
SCNAVTA Chapter Name and State:
New AdvisorReplacing Advisor
If you are replacing a previous advisor, what is their name?
Advisor #2:
Full Name*

First NameLast Name
Credentials:*
Email Address:*
example@example.com
Home Address:*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Phone Number:*
Format: (000) 000-0000.
Which program did you graduate from?*
Year of graduation:*
Have you previously been a NAVTA member?*
New AdvisorReplacing Advisor
If you are replacing a previous advisor, what is their name?
Should be Empty:

Advisor #1: