Please provide the following information and click the "Submit" button when finished.
Name:
Home mailing address:
City, state and zip code:
Phone:
E-mail address:
Place of employment:
Address of employment:
State of licensure:
License number:
VT program attended:
Year of graduation:
New Member
Renewal
Individual that is registered, certified or licensed and is a graduate of an AVMA program
Full - $30.00
Individual working in a veterinary practice that has not graduated from an AVMA accredited program*
Associate - $20
Individual that is enrolled as a student in an AVMA accredited program*
Student - NO charge
Business or group interested in veterinary technology and the goals of the organization*
Organization - $30.00
Interested in becoming a committee member? Check all areas of interest.
Date submitted:
* may not vote, hold elective office or sit on the Board
Once you click submit, the form will not clear. Please click submit once only. You MUST complete both the application online AND the Paypal information to pay online.
If you prefer to pay by check, please mail check to:
MVTA
Attn: Jodelle Rhodes, RVT
900 East Campus Drive
Columbia, MO 65211
