Below is the application/work experience form.  Please fill this form out and submit it by August 1st, 2017.  Please fill out this form AFTER you have read the requirements from the bylaws and feel you meet those requirements.  At the bottom of this page there is a non-refundable fee of $25.00 to be paid at the time of application.  Please add that to your cart after submitting your form and then proceed to checkout.  Once your information has been received and reviewed you will be contacted by an AVOT board member to continue with the application process.  If you do not provide ALL of the requested information your application will be rejected.

To view the entire application timeline please click HERE

Name *
Name
Mailing Address *
Mailing Address
Primary Phone
Primary Phone
Work Phone *
Work Phone
Check Appropriate Credential *
Please provide ALL Ophthalmology work experience information in the box below. Each place of employment MUST have the following information listed: -Date of Employment (From: MM/YYYY, To: MM/YYYY) -Name of the place of employment where the Ophthalmology experience was obtained -Description of Primary Responsibilities Related to Ophthalmology (list role, duties, and type of practice (small animal, university, large animal, etc.)
Additional Required Information: *
I understand that I need to provide two letters of recommendation as stated in the applicant requirements. These letters are to be directly sent to avot_vts@yahoo.com by the authors after this form has been submitted. I will also email proof of my current NAVTA membership and current technician license. I will submit the required applicant fee (see below this form). I understand that this fee is non-refundable and it must be submitted on the same day that I submit this form.
AVOT Application Fee (non-refundable)
25.00

This fee is to be paid at the time that you submit your application form.  If no fee is paid the application will not be accepted.  This fee is non-refundable. Please be sure to read ALL of the requirements before submitting your application! There are no refunds!

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