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Please complete the following form to request Registered Veterinary Technician membership in AABP

 

First Name:
Last Name:
Company/Office:
Address:
City:
State/Province
(ex, NY, WI):
Country:
Zip:
Phone:
Email:

Member Demographics:

In an effort to identify, recognize and celebrate the diversity of AABP members, please complete the following.

Gender:       Race:       Ethnicity:

AABP Member Sponsor Name:
AABP Sponsor Member Number:

Veterinary Technician License:

AABP must submit the state/province license number of attendees to RACE after conferences and webinars. RACE only requires one state/province license to be entered. If you are licensed in more than one jurisdiction, RACE will apply your CE to all jurisdictions in which you are licensed, therefore only submit ONE jurisdiction and license number.

If you decline, your CE attendance will not be submitted and may not be approved by RACE even if you have a certificate of attendance.

State/Province:    Number:

 
District:
 0 - International
1 - NH, RI, CT, NY, MA, VT, ME
2 - VA, PA, MD, DC, DR, NJ
3 - FL, GA, MS, SC, TN, NC, AL
4 - KY, MI, OH, WV
5 - IL, IN, WI
6 - MN, IA
 7 - MO, OK, KS
8 - AR, LA, TX
9 - CO, ND, WY, NE, UT, NM, SD
10 - HI, AZ, CA, NV
11 - WA, MT, OR, AK, ID
12 - PE, QC, NS, NB, NL, ON
13 - SK, BC, AB, MB
  security code
Enter Security Code: