Registration Form                                                                                                                                       
 Please complete the following information.         

Registrant Information                                                                                                                                                                     

 Last Name:  First Name:    Middle Initial:       

 Preferred First Name or Name You Go By (for badge):

 Are you a UGA Vet Med alumni?   If so, specify class:  
 Do you have special physical requirements?    If so, explain:  
 Do you have special dietary requirements?     If so, explain:

Contact Information                                                                                                                                                                        
 Preferred contact location:          Is this a new address?


 City:   State:    Zip:

 Home Phone (enter as 111-222-3333):   Cell Phone (enter as 111-222-3333):

 Email Address:

 Business Name:

 City:   State:      Zip:

 Business Phone (enter as 111-222-3333):  

 Email Address:    


Event Selection Options

 Please select the conference and activities that you would like to attend. Please note that lunches are NOT included with the conferences.

Veterinarians: Conference Options

Lunches and Reception



CVM VCAR Release 3.0