Association for Veterinary Epidemiology and Preventive Medicine

 Print out, complete, and return the form below and dues (US $20.00 ) to:

Dr. James Thorne, Secretary/Treasurer, AVEPM
3310 Cheavens Rd
Columbia, MO 65201-9383

Pay online through

E-mail AVEPM at

NEW APPLICATION ___ RENEWAL ___ CHECK ENCLOSED ___ PAID ONLINE THROUGH PayPal ___ DATE: _____/____/____ NAME: _____________________________________________________ First M.I. Last E-mail address: ______________________________________________________ Mailing address: ______________________________________________________ ______________________________________________________ ______________________________________________________ City State Zip Code _________________________ Country Business Phone: (_____)___________________ FAX: (_____)______________________________ E-Mail: __________________________________ Degrees: __________________________________________________ Board Certification: ______________________________________ Present Position: _________________________________________ _________________________________________ Major area(s) of current activity in veterinary public health and preventive medicine: ___________________________________________________________ ___________________________________________________________ Membership dues are payable to AVEPM on January 1 of each year. The AVEPM Constitution and By-Laws require that members two years in arrears in payment of dues shall be dropped from membership (Article VI)