Regional Wet Lab Registration FormTo register, please complete this form and we will be in touch shortly! Name * First Name Last Name Email * Phone (###) ### #### What is your occupation? * Farrier Veterinarian Vet Tech or Vet Assistant Veterinary Student Farrier Apprentice / Student Equine Practitioner - Other Industry Representative If you chose other, please provide a brief explanation Address Address 1 Address 2 City State/Province Zip/Postal Code Country Current Member of the NAEP? Yes No Event Choice Select which event you would like to attend from the list below March - San Antonio, TX April - Memphis, TN May - Seattle, WA Amount to be paid Please select the correct amount determined by current membership status Member - $250 Non-member - $350 Student - $125 Payment - Credit Card # * Credit Card Type Visa Mastercard AMEX Expiration Date * MM DD YYYY CVC * Name on card First Name Last Name Billing Address (if different from above) Thank you!
