AGV MEMBERSHIP APPLICATION FORM

SURNAME: .......................................................................................................

FORENAME: .....................................................................................................

TITLE: ................................................................................................................

DATE OF BIRTH: ..............................................................................................

GRADE: .............................................................................................................

DIVISION / AGENCY : .......................................................................................

LOCATION: .......................................................................................................

BVA MEMBER ? YES / NO*

I wish to apply for full / associate * membership of AGV. ( Full membership is only available to members of BVA ).

Signature: ............................................................................................... MRCVS

* Delete as appropriate

Please complete, print and send this form, together with the Bankers Order (on the following page) to:

Stewart Donald, Hon. Secretary AGV, Longman House, 28 Longman Road, Inverness IV1 1SF. Please ignore proposer/seconder as this will be addressed by Council.

The completed forms will then be forwarded by the Secretary, after membership has been approved, to:

Fred Landeg, Hon. Treasurer AGV, 6 Oak Tree Copse, Tilehurst, Reading, Berkshire
RG31 6PX

Proposed by: ........................................................................................... MRCVS

Seconded by: .......................................................................................... MRCVS

THE ABOVE DETAILS WILL ONLY BE DISCLOSED TO AGV COUNCIL MEMBERS