Online Registration Name VeterinarianRegistered TechnicianAssistantStudentVendor email Phone Fax I would be interested in being considered for an office in the IAEP Yes No Suggested Topics / Speakers for future meetings Note: This information will be published in a PUBLIC online directory. Practice/University/Company Name Practice Address City State Zip County Practice email Practice Website Additional Attendees from your Practice to be included in the online Payment: Name VeterinarianRegistered TechnicianAssistantStudent email Consider for Office? Yes No Name VeterinarianRegistered TechnicianAssistantStudent email Consider for Office? Yes No Name VeterinarianRegistered TechnicianAssistantStudent email Consider for Office? Yes No Name VeterinarianRegistered TechnicianAssistantStudent email Consider for Office? Yes No Name VeterinarianRegistered TechnicianAssistantStudent email Consider for Office? Yes No Students: Free of Charge Veterinarians: $75.00 each Registered Technicians and Assistants: $55 each Vendors: $300/meeting Total Due: $ Note: You will need to re-enter this total in the next step.
