BSVTA CE Member Registration

Thank you for registering for our CE event on January 25, 2020. Please fill out the form below to submit your registration electronically. You will be directed to PayPal to pay the registration fee once you hit submit.

    Your Name or Business Name (required)

    Name of all registrants you are signing up (if signing up on behalf of a group or business)

    Your Email (required)

    Clinic Name (required)

    Home Address (required)

    City (required)

    Zip Code (required)

    Phone Number (required)


    Questions? Contact Anni

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