Seattle-King County Veterinary Medical Association / Membership Info

Seattle-King County Veterinary Medical Association

website maintained by
SKCVMA-PIC
(Public Information Committee)

Please fill out this form if you would like to join SKCVMA or are renewing membership. The information will be forwarded to our membership department. You may also contact Dr. Maria Moody at 425-478-1599 and she will fax a membership application. If you have any questions, please use the "Contact Us" form to send us an email.

Membership costs $95 a year and includes our monthly newsletter "Vet-Rap", access to CE notes online, and a link on our "find a vet" page if you are a clinic owner or medical director. Members can also sign up for the UW CE lecture series for $90/year. Nonmembers are welcome to attend any UW CE lecture for $40. Vet students and technicians can attend for $7.50. Combined Chapter CE meetings are free to members, $10 for nonmembers, and are held the first Wednesday of every other month (see our calendar) at North Seattle Community College.

After you complete the form, you can use PayPal for immediate dues payment, otherwise Dr. Moody will contact you regarding dues. Please note: you must do a separate PayPal payment and application form for each member you are paying for, if a multiple member practice.

Form - Membership Info Form

Name (required)
First Name (required)	Last Name (required)

Work Address
Street Address


City	State/Province	Zip/Postal Code
,

Practice Name, Relief, or Retired (required)

Phone Numbers

Work Phone

Fax

E-Mail Address (required) :

Please indicate how you want to receive the monthly publication, Vet-Rap

Preferred address for Vet Rap; if not email, please give it in the next address area (required)
email
work
home

Mailing Address for VET-RAP (if you do not fill this out, email is your assumed delivery mode)
Street Address


City	State/Province	Zip/Postal Code
,

Would you like to be included on an email reminder list for upcoming SCKVMA CE and events?
(If you do not check a box, you will be included on this list)
yes
no

Would you like to volunteer for any of these committees?
Continuing Ed
Professional mediation
Disaster Preparedness
Membership
Community Service
Public Information
Chapter Chair

Your name and contact information will be publically listed on our website for any of the following:
Medically proficient at foreign language (specify below)
Make housecalls (indicate area below)
Practice complementary medicine
Practice on exotics (please list below)

Please type any details for above question here

Are you a clinic owner or medical director? (if yes, your hospital will be listed on our website) (required)
yes
no

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Verification Code :

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