NABV/SNABV Membership Application 2023

NABV/SABV Membership Application

Last Name *

First Name *

M.I.

Gender

Male

Female

No Response

Date of Birth: +

Email Address *

Preferred Mailing Address *

Home

Office

Address *

City

State

Zip

Phone *

PROFESSIONAL INFORMATION (for professional members only)

School Attended:

Graduation Year: +

Degree Earned

DVM

Other

If other: (please specify):

Practice Area:

Years In Practice:

Certifications (list all that apply)

Licensure Number:

State

Expiration: +

Licensure Number:

State

Expiration: +

Professional Title:

COLLEGIATE INFORMATION
(for undergraduate, graduate, and professional school members only)

School Attending:

Anticipated Graduation Date +

Degree Sought:

Previous Schools Attended:

Career Interests

Matriculation Level:

HIGH SCHOOL INFORMATION
(for 9-12 grade Jr. SABV members only)

School Attending:

Anticipated Graduation Date +

Career Interests

Extra-curricular Activities:

Awards/Honors:

Grade Level

MEMBERSHIP CATEGORIES:
NABV Professional Membership | Open to all DVMs licensed to practice
veterinary medicine in any state or territory within the United States (U.S.A.), the
District of Columbia (D.C.), and abroad

NABV Affiliate Membership | Open to all non-DVM professionals

SABV Graduate Student Membership | Open to all DVM students and graduate
students of other disciplines

SABV Undergraduate Student Membership | Open to all undergraduate animal
science majors and undergraduate students of other disciplines

Jr. SABV High School Student Membership | Open to all high school students

DUES & PAYMENT INFORMATION*

Check one membership type below: *

NABV Professional Membership ($100)

NABV Affiliate Membership (for non-veterinary professionals) ($75)

Graduate/Professional Student Membership | Student Association of Black Veterinarians (SABV) ($50)

Undergraduate Student Membership | Student Association of Black Veterinarians (SABV) ($25)

High School Student Membership | Jr. Student Association of Black Veterinarians (Jr. SABV) ($10)

Check all that apply: I am interested in receiving more information about...

Chartering a collegiate chapter

Participating in K-12 outreach efforts (Jr. NAVB & Elementary/Middle School Activities)

Joining the Publications Committee

Joining the Professional Development Committee

Starting a Specialty Committee

Mentoring | Pre-Professional Level

Mentoring | Professional Level

Add NABV Conference and SAVE 20%. (Note: Figures do not include membership fees)

NABV Professional ($250) NOW $200.00

NABV Affiliate ($200) NOW $160.00

SABV Graduate Level ($100) NOW $80.00

SABV Undergraduate Level ($75) NOW $60.00

Jr. SABV (Free)

Add NABV Conference and SAVE 20%. (Note: Figures do not include membership fees)

NABV Professional ($250) NOW $200.00

NABV Affiliate ($200) NOW $160.00

SABV Graduate Level ($100) NOW $80.00

SABV Undergraduate Level ($75) NOW $60.00

Jr. SABV (Free)

*Please note that all fees are non-refundable.