Minnesota Veterinary Medical Association - Certification Application

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Application for Veterinary Technician
Certification

First Name:

Middle Initial:

Last Name:

Address:

City:

State:

Zip:

Phone:

Email Address:

Date of Birth:

	I am a graduate of an AVMA accredited program in Veterinary Technology School Attended: required Year of Graduation: required
	I am currently certified/registered/licensed as a veterinary technician in the state of:

To become certified, candidates must pass the Veterinary Technician National Exam.
To register for the National Exam,
you must register through the AAVSB website at www.aavsb.org.

Certification Fee is $60.

Please select payment method:
Visa MasterCard Discover American Express

Credit Card Number:

Credit Card Exp:

CVV Code:

cvc code

Please send a copy of your diploma or official transcript from your school to:
Minnesota Veterinary Medical Association
101 Bridgepoint Way, Suite 100
South St. Paul, MN 55075
If you have any further questions, please call the MVMA OFFICE at 651-645-7533.

Minnesota Veterinary Medical Association
Copyright © 2013