Attendee Event Registration Form
Please fill out one form for each attendee.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Role (SELECT VETERINARIAN TO SEE WET LAB AVAILABILTY)
*
Veterinarian
Veterinary Technician (credentialed)
Veterinary Assistant/Technician (non-credentialed)
Manager
Client Service Representative
General Attendee
License Number
*
Must enter state and license if applicable - for DVMs and licensed technicians
State of Licensure
*
Sunday Symposium Only ($125 for non-DVMs, $225 for DVMs)
Saturday Wet Lab and Sunday Symposium Bundles (DVMs only, choose one only)
Hidden duplicate
Behind the Scenes Selection (select one)
*
Family El Paso Zoo tickets, EPVMA Discount - $12.00
Hidden zoo price
Hidden subtotal
Do you have a Promo Code?
*
Yes
No
Promo Code
Subtotal
Hidden total with CC fee
Payment
*
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( X )
USD
This amount includes your total with a 3% credit card fee.
Credit Card
Submit
Should be Empty: