Active Association Membership Application Form


FOR NEW APPLICANTS
If you took the VTNE inYour Dues areYour CE Requirements areYour Membership/Certification will be valid until
June 2006 $106 16 hours June 30, 2008
January 2007 $53 8 hours June 30, 2008
June 2007 $53 8 hours June 30, 2008
January 2008 $30 4 hours June 30, 2008
June 2008
 $120 16 hours
 June 30, 2010


FOR RENEWING AND TRANSFERRING APPLICANTS

If you are joining or renewing Your Dues are Your CE Requirements are Your Membership/Certification will be valid until
before July 1, 2007 $106 16 hours June 30, 2008
on or after July 1, 2007 $53 8 hours June 30, 2008
If you are transferring in after January 2008 $30 4 hours
June 30, 2008
on or after July 1, 2008 $120
 16 hours
 June 30, 2010
Contact Information
By providing an email address, you authorize CACVT to email information such as “Enformation” which is the most up-to-date events. CACVT will never give out email addresses to any other entity. You may opt out at any time.
Other Information
You may change your method of newsletter delivery at any time.
Education & Certification
Current NAVTA members or VTS receive a discount on membership (fields must be filled in).
If transferring from another state, on what date did you request your scores be sent to Colorado?
Month/Day/Year
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