Please complete the following form
to request Registered Veterinary Technicians/Technologists Membership in AABP

First Name*:
Last Name*:
AABP Member Sponsor Name:
AABP Sponsor Member Number:

Member Demographics:

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

Gender:       Race:       Ethnicity:

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:


RVT School:
Grad Year:
By checking this box, I certify that I am a registered/credentialed veterinary technician and have graduated from a veterinary technology school
District of
Address Above:
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
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