MEMBERSHIP APPLICATION

Membership must be renewed on a biennial basis. Membership dues must become payable January 1 and must be remitted to the Treasurer. A person who fails to pay dues for six months after the due date will be designated not in good standing and will not be eligible to vote or hold office until the arrears and the ensuing two year's dues are paid in full. Persons whose dues are in arrears for two full years will be disassociated from the Society after due notice has been given. To renew your membership and continue enjoying the benefits of being a member of STVM, please complete the form below (or the   Printer Friendly Version ) and return it to Dr. Edmour Blouin or Dr. Katherine Kocan. To update your contact information or for further information contact the Secretary-Treasurer

Mark your calendars for STVM-12 in Phuket, Thailand!

STVM membership dues, due in January, must be current in order to be eligible for the reduced member registration rates for the STVM Biennial meetings.

Dues for two years are: US$80 for Professional  Members; US $40 for Professional Members  from FAO LIFDC country*;  and US$20 for students (students must indicate degree program status).                                                                                                                                                                       Dues may be paid in US dollars by VISA or Mastercard or by check in US dollars (drawn on a U.S. affiliated bank).  Cash will be accepted if paying in person only;  Please do not remit cash via the postal service.

Please complete this renewal application and return with payment information by postal service  or e-mail to the address listed below.

Name_______________________________________________________________________________

Professional Affiliation__________________________________________________________________

Mailing address_______________________________________________________________________

                                 Street                                        City                           Postal Code

If paying by mail, send this form to:             If paying by e-mail, submit this form to:

Blouin/Kocan,  STVM Secretary-Treasurer                                  Edmour.Blouin@okstate.eduor

Department of Veterinary Pathobiology                                     Katherine.Kocan@okstate.edu

250 McElroy Hall, Center for Veterinary Health Sciences

Oklahoma State University

Stillwater, OK  74078-2007, U.S.A.

Amount of Payment Enclosed (choose one):

• Professional  Membership for 2010 & 2011, US$80.00 _________________.
• Professional Membership for 2010-2010 from an                                                                                      FAO  designated LIFDC* country  US$40__________________.
• Student Membership for 2010 & 2011, US$20.00 _________.  Degree/status________________.

*For the status of your country as an FAO low-income food-deficit countries (LIFDCs), visit the website:

www.fao.org/docrep/meeting/004/y6691e/y6691e00.htm

Please check one:

  ______­­Check       _____VISA   _____  Mastercard   ____Cash                     

Credit card information:

Name as it appears on the credit card______________________________________________________

Credit Card Number_______________________________________ Expiration Date________________