Association of Veterinary
Hematology and Transfusion Medicine

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Membership Application

Name: _______________________ Daytime Phone: ___-_________

Address: ________________________________________________

Email: ____________________



I would be interested in serving as a committee member or board member. _____
 

New online directory! AVHTM is in the process of setting up an online directory
for members.  Current plans are that it will be password-protected, and access will
be limited to current AVHTM members.  You will be included in the directory, unless you specify otherwise below:

Please DO NOT LIST: ___At all    ___Phone    ___Address    ___Email

Help shape the upcoming SIG for 2010!  Please share any ideas that you may have for topics or speakers in the space below.

______________________________________________________________

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Membership dues: $35 individual, $5 student, $75 for institutional membership (6 or less)

Please send your application and dues check (payable to AVHTM) to:

Dr. Larry DeLuca
AVHTM Executive Director
2509 North Campbell Ave, #304
Tucson, AZ 85719-3304