Membership

[Company Logo Image] AVMS

Membership

ALABAMA VECTOR MANAGEMENT SOCIETY

REGISTRATION FORM

NAME: ___________________________________________________

AFFILIATION: ___________________________________________________

ADDRESS: ___________________________________________________

CITY, STATE, ZIP: ___________________________________________________

TELEPHONE: ___________________________________________________

E-MAIL ____________________________________________________

[ ] PRE- REGISTRATION ( BEFORE MARCH 1 1008) $75.00

[ ] REGISTRATION (AFTER MARCH 1, 2008 OR ON SITE) $90.00

[ ] STUDENT REGISTRATION $25.00

AMOUNT ENCLOSED ________________________

MAKE CHECKS PAYABLE TO:

Alabama Vector Management Society

Matthew Smith... Secretary Treasure

Mobile County Health Dept.

750 Congress St.

Mobile, Ala. 36603

(251) 690-8910

For a Printable Version Click Here!!!

For Vender Information Contact:

Drew Lockhart...Vender Liaison 4904 Preakness Circle Brownsboro, Ala. 35741 256-536-3134 DLockhart@central.com

I UNDERSTAND THAT, AS A MEMBER OF THE AVMS, I AM EXPECTED TO ADHERE TO THE AVMS CODE OF ETHICS.

*Registration/Membership dues are for AVMS membership year 2008.

For a Printable Version For Venders Click Here!!!