HCVMA Membership Application

Membership Application Process

If you are not a current member but have been a member in the past, please fill out the Contact Us form and our executive secretary will email you instructions on renewing your membership.

If you have NEVER been a member of HCVMA before, please fill out the application below and click “Submit.” You will receive an email confirming receipt of your application. Within a few days of submitting your application, you should receive an email with your login information for the Members section of our website. You will then need to login and pay your dues online to gain permanent access. Your membership will be officially approved at the next board meeting. In the meantime you will have all the rights and privileges of a member.

* Required

First Name *
Last Name *
Middle Initial
Email Address *
Business Street Address *
Business State *
Business City *
Business Zip Code *
Business Telephone *
Business Fax
Business Website Address
Home Street Address
Home City
Home State
Home Zip Code
Home Telephone
Home Fax
Home Email Address
Preferred Email Address *	-- Please select -- Business Email Home Email
How would you like to receive your newsletter? *	-- Please select -- Email Hard Copy Both
Birth Place
Birth Date
School and Year of Graduation *
Degree(s)
Professional Activity Code	-- Please select -- 10 - Bovine Practice (exclusive) 11 - Equine Practice (exclusive) 12 - Porcine Practice (exclusive) 13 - Large Animal Practice (all species) 14 - Mixed Practice (predominantly large) 15 - Mixed Practice (50-50 Large & Small) 16 - Mixed Animal Practice (predominantly Small Animals) 17 - Small Animal Practice (exclusive) 18 - Poultry Practice (exclusive) 19 - Feline Practice (exclusive) 20 - Anatomy 21 - Biochemistry 22 - Microbiology 23 - Parasitology 24 - Pathology 25 - Pharmacology 26 - Physiology 27 - Radiology 28 - Toxicology 29 - Surgery 86 - Anesthesiology 87 - Internal Medicine 88 - Cardiology 89 - Dermatology 90 - Neurology 91 - Epidemiology 92 - Oncology 93 - Aquatic Animal Medicine 94 - Avian Medicine 95 - Ethology 30 - Veterinary Public Health 31 - Veterinary Preventative Medicine 32 - Teaching and Research 36 - Regulatory Veterinary 38 - Administration 41 - Laboratory Animal Medicine 82 - Ophthalmology 83 - Nutrition 84 - Clinician 85 - Theriogenology 80 - Pathology/Avian 81 - Pathology/Clinical 42 - Wildlife/Zoo & Fur Bearing Animals 43 - Extension 44 - Diagnostic Veterinary Medicine 45 - Industrial Veterinary Medicine 50 - Military Veterinary Service 55 - Veterinary Technician Educator 60 - Other Veterinary Medicine 70 - Retired 99 - Unknown
Employer Type *	-- Please select -- 01 - College or University 02 - Federal or Dominion Government 04 - State or Local Government 06 - Self-Employed Practice - Owner or Shareholder 07 - Private Practice Employee 08 - Retired 30 - Other
Spouses Name
Previous Practice Locations
Board Certifications
Do you agree to abide by all the rules and resolutions adopted by a majority of this organization in the past, present and future? *	Yes No
Texas License Number *
Practice *
Position *
Nickname
Specialty(s)
Opt-in to be included in the Vet Finder *	Yes No
Cell Phone *
Enter Word Verification in box below *