Connecticut Veterinary Technician Association / CTVTA Board Nomination Form

Connecticut Veterinary Technician Association

Central Hospital for Veterinary Medicine, 4 Devine
North Haven, CT 06473

(203)865-0878

www.ctvta.org

Name (required)

First Name (required)	Last Name (required)

E-Mail Address (required) :

Phone (required)
Phone Type	Phone Number (required)

Is there a specific board position you would like to be considered for?

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