AAFSV Membership Application

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I desire to become a member of the American Association of Food Safety Veterinarians and enclose payment of dues for the year 20___.

Name:

Mailing Address:


Email address:

Phone Number:

Organization/Employer:

Position:

Veterinary Degree (date and institution):

Other Degrees:

Board Certification/Specialty:

Are you a member of the AVMA/SAVMA? ( ) Yes ( ) No
Membership in Other Professional Organizations/VMAs:



Signature

Date

Submit completed application to:
American Association of Food Safety Veterinarians
1730 S Federal Hwy 205
Delray Beach, FL 33483 or email to AAFSV EVP listed below;

Questions: Contact Executive Vice-President (EVP) Dr. Eric Willinghan, AAFSV.execvp@gmail.com

Annual dues are $52.00 (US, Canada & Mexico), $62.00 other international, $10.00 Student Members. New members paying their initial dues during the last quarter of the year are credited with dues payment for the next calendar year. AAFHV dues may be deductible on federal income tax returns as business expenses, but are not deductible as charitable contributions. (Members should refer to most recent laws regarding federal income tax deductions.)

Electronic payment procedures available upon request.

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