Vet Finder Participation Application

Please print out the following application. If necessary, you may request one by fax or mail by calling 800-APA-PETS ext.152 or e-mailing to apa@apapets.com.

A separate application is required for each facility. Questions 10-12 do not appear on your Web Site. Please print all answers clearly.


1) Your Name _________________________________

2) Facility Name _________________________________

3) Facility Address _________________________________

_________________________________

_________________________________

4) Facility Phone and Fax Numbers (____)___________(____)___________

5) Names of the others doctors at the facility _________________________________

_________________________________

6) What type of practice do you operate? _________________________________

7) How long have you been practicing veterinary medicine? _______year(s)

8) How long has this facility been in operation? _______year(s)

9) Are you a member of local or national veterinary organizations? If so, which ones?

______________________________________________________________________________________

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10) What is your total client base? _________________________________

11) How many sedated procedures does your facility average a month? _______/mo

12) What are the total required costs for the spay of a 50 lb. dog and what does this include?

$___________ _______________________________________________________________________

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13) What client services do you offer? ___________________________________________________________________________

___________________________________________________________________________


14) Key staff members and their positions ____________________________________________________________________________

_________________________________________________________________________________________

Use this space to describe your facility as you would like it to read on your web site. You may use up to 200 words, however, under 100 is usually acceptable. You may want to include directions to your facility.

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Do you currently have a web site on the Internet? If so, what is your web address (URL) http://____________________

What would you like your APA web address to be (up to 7 digits)? www.apapets.com/_________________.htm


Your web page will be posted 7-10 days after receipt of this form. If you would like verification by mail please check here. __

I certify that all answers given on this application are true to the best of my knowledge and that neither I, nor my facility or its employees, are engaged in any illegal or inhumane activities. I understand that persons referred by the American Pet Association to me or my facility may or may not be pre-qualified as responsible pet owners.

___/___/___ __________________________________________________
Date -------- Facility Owner Signature

Please send me information about the following American Pet Association Programs:

___ Membership Services ___ Advanced Pet Registration and Active Recovery System
___ Media Services/Research Department ___ VIP Program for Veterinarians
___ Breeder Referral Service ___ Humane Center Donation/Fundraising Programs
___ Additional Vet finder Application(s) Number requested _______

Fee: 12 months $199.00
Options: Extra Photo/Logo $10.00

___ I have enclosed a check

Please charge my ___ Visa ___ Mastercard ___ Discover
__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ EXP. __/__/__

Please mail this completed application and fee
along with up to two photos/logos to:

American Pet Association
Attn: Web Development
P.O. Box 7172
Boulder, CO 80306-7172