Connecticut Veterinary Technician Association

Central Hospital for Veterinary Medicine, 4 Devine
North Haven, CT 06473

(203)865-0878

ctvta.org

CVT Membership Renewal Form Form

Name (required)
First Name (required)
Last Name (required)
E-Mail Address (required) :
Address (required)
Street Address (required)
City (required)
,
State / Province (required)
Zip / Postal Code (required)
Phone (required)
Phone TypePhone Number (required)
Membership Number (required)

Hospital Name

Hospital Address
Street Address
City
,
State / Province
Zip / Postal Code
Hospital Phone
Phone TypePhone Number
CE Submission
You are not required to submit your CE Certificates for renewal. Please retain your certificates for your records. The CTVTA Membership Committee will be randomly auditing the CE compliance of its members, so you may be asked to provide proof of CE attendance to the CTVTA Membership Committee; failure to do so may result in the suspension or loss of my status as a Certified Veterinary Technician.
2018 CEU Submitted for 2019 Renewal - CE title - Date of CE - Number of CEU earned are required to be listed here: (required)


Check the reCAPTCHA to ensure you are not a robot: