Download Companion Animal Behaviour Therapy Study Group

British Veterinary Behaviour Association (BVBA)
Membership Application Form
(Please print and send to the address below)
New member
Renewal
(Please tick)
I wish to apply for membership of the Study Group for 1st January 2017 to 31st
December 2017.
I agree to pay the current subscription and to abide by the working rules in accordance with the constitution of the
group (see website for details).
SECTION 1: PERSONAL INFORMATION
SURNAME:
TITLE:
FIRST NAME:
Address (Home)
Address (Journal delivery if different)
Number and Street:
Town/City:
County:
POSTCODE:
TELEPHONE NUMBERS:
HOME:
WORK:
MOBILE:
E-MAIL:
How did you hear about us:
(NOTE: PLEASE ENSURE E-MAIL IS ACCURATE AND INDICATE UNDERSCORE_ VERSUS HYPHENIF APPLICABLE. IT IS VITAL THAT WE HAVE THE CORRECT DETAILS AS MOST OF OUR
CORRESPONDENCE USES YOUR E-MAIL ADDRESS)
USE OF YOUR PERSONAL INFORMATION:
BVBA will not disclose any personal information given by our membership without the permission of the
individuals concerned.
As our membership have voted to subscribe to the ‘Journal of Veterinary Behaviour’ for the next 12 months we
will need to pass delivery addresses and /or email for our membership to Elsevier (the Journal’s publisher) to
enable delivery of the Journal ether hard copy or on line to each member.
Signature:
Date:
SECTION 2: MEMBERSHIP CRITERION:
Membership of BVBA is open to individuals working within the veterinary profession or those working/
interested in the field of companion animal behaviour. Please indicate if you belong to any professional bodies
which support your application for membership, for example RCVS, BSc, BA or Post Graduate Qualification etc
Veterinary surgeon: Yes
No
Veterinary Nurse: Yes
No
Member of BSAVA: Yes
No
Other degree or qualification (Please specify)
Please also detail if you belong to any relevant trade or charitable organisations e.g. APBC, APDT etc
If none of the above applies, please support your application with a letter/CV detailing any appropriate formal
qualifications you hold and your experience in the companion animal behavioural field.
SECTION 3: MEMBERSHIP FEES: including journal (please tick appropriate boxes)
The membership fee is £9.00 less if you choose to take the on line version of the Joutnal
TYPE OF MEMBERSHIP
INDIVIDUAL (Includes 1 copy
of each issue of JVB)
PRACTICE :maximum of 5
people*
(Includes 1 copy of each issue of
JVB for the practice)
CORPORATE: 10 people*
(additional members can be
added on request)
(Includes 1 copy of each issue of
JVB for the company)
Journal distribution
HARD tick
COPY
BVBA
£70
BVBA & ESVCE
£85
BVBA STUDENT
£58
BVBA / ESVCE
£74
STUDENT
BVBA
£121
BVBA & ESVCE
£200
FEES
BVBA
BVBA & ESVCE
£200
£360
online Tick
Cheque Paypal
£61
£76
£49
£65
£112
£191
£191
£351
* To qualify for practice/ corporate membership each individual within the group must submit a copy of
this form completing sections 1 & 2. Each member must fulfil the criteria for membership and we will need
contact details for all of you for correspondence and also to enable your registration on the e-mail
discussion forum.
If applicable and you opt for a printed hard copy please ensure that you identify which address you require
your hard copy of the JVB to be sent to.
Payment may be through the website with Paypal or Cheques should be made payable to BVBA and
forwarded to:
Kevin McPeake
BVBA Membership Secretary
8 Blyton Grove, Doddington Park, Lincoln, LN6 3NQ