Columbus Academy of Veterinary Medicine

COLUMBUS ACADEMY OF VETERINARY MEDICINE c/o Dawn Bookmyer 9540 Dublin Road, Powell, OH 43065

MEMBERSHIP STATEMENT 2014 September 6, 2014

The Columbus Academy of Veterinary Medicine (CAVM) serves its members in a variety of ways including continuing education opportunities, promoting veterinary medicine in central Ohio, and linking local veterinarians with the public sector. The membership dues for the year are $60.00

Please take a moment to complete all of the membership form and mail it along with your yearly dues to the address noted below. Thank you for your support. The information is going to be listed in the Members Only area of the CAVM Website and will not be available to anyone except the members.

Membership Information:

Name: ______

Address: ______

City: ______State: ______Zip Code ______

Phone:______(home) E-mail: ______(Optional-CAVM use only) (Where you want to get information)

Cell: ______Clinic Name: ______

If paying my check please make it payable to: Columbus Academy of Veterinary Medicine and mail to: CAVM, c/o Dawn Bookmyer, 9540 Dublin Road, Powell, Ohio 43065 or if paying with credit card please go to the website and pay online via Paypal. The above information can be entered there electronically. Thank you.

Enclosed: Membership dues $ 60.00

We would appreciate your comments to the following: 1. Would you be willing to volunteer for a Rabies Clinic? Yes ____ No ____ 2. Would you be willing to serve on the CAVM Board – 2014? Yes ____ No ____ 4. What changes would you like to see/comments on the back of this application? Thank you for taking the time to reply.