New Mexico Veterinary Medical Association
Membership Application

We are currently not accepting credit card information for Membership Application payments over the internet. Please fill this form out, print it and either fax or mail it. No information can be retrieved from this form over the internet.

Name - Last First DVM VMD

Practice or Facility Name

Practice Address

City State Zip

Email address

Graduated from Grad Year

Spouse Name

Are you a new graduate applying for a free first-year membership? Yes No

Veterinary License # State of Licensure

MC VISA AmExp

Credit Card # Expires

I hereby authorize the NMVMA to charge my account for this purchase.

Name as it appears on the card

Dues are payable by cash, check, debit or credit card in the amount of $150 per year and are billed and payable in June of each year for the period from July 1st through the following June 30th. New graduates are entitled to the first year membership at no cost, and a second year at ½ of full price. New graduates should send in a completed application and a photocopy of their diploma without payment to be listed as a member and to receive membership confirmation. All other new applicants should submit full dues payment along with this application. Credit or debit card users should complete the additional information above.

Fax or mail to:
Tamara Spooner
60 Placitas Trails Road
Placitas, NM 87043
Fax: 505.771.8963

New Mexico Veterinary Medical Association Membership Application

New Mexico Veterinary Medical Association
Membership Application