IAAAM

International Association for Aquatic Animal Medicine

International Association for Aquatic Animal Medicine
New Member Profile Form
Do not forget to go to dues payment page when you finish entering your profile.

First Name

Preferred Name

Use this field if you prefer a name that is not your listed first name for IAAAM correspondence.

Middle

Last Name

Email Address

Address 1

Address 2

City

State/Province

Zip Code

Country

Phone Number

Title

(Dr, Mr, Mrs, etc.)

Degrees

(PhD, VMD, DVM, MD, etc.)

Professional or Educational Affiliation

Number of Years in Aquatic Animal Medicine

(Educational and/or professional)

For Student Membership Only

Complete this section if you are a current student, intern or fellow registering for a student membership.

Program

Include your school and field of study.

Estimated Completion

Advisor

Please include the name and contact information for your advisor including email and/or phone number and have your advisor send an email confirming your student status to Membership@iaaam.org.

For Full Membership Only

IAAAM Member Sponsor

New members are required to have a signature of a current voting member of IAAAM. Please include the name and contact information of your sponsor including email and/or phone number and have your sponsor send an email confirming this to Membership@iaaam.org.

Membership Directory

Include my Name, Email, Affiliation, and Phone Number in the IAAAM Membership Directory. (Leave field(s) blank above to omit just your affiliation and/or phone number.)

Do not include me in the IAAAM Membership Directory.