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AMERICAN REGISTRY OF PROFESSIONAL ANIMAL SCIENTSTS
PRINT THIS FORM AND SEND TO: FOR OFFICE USE ONLY
ARPAS
1800 S. Oak Street, Suite 100, Champaign, Illinois 61820-6974
217/356-5390
217/398-4119 (FAX)		 Submitted:
Approved
Certificate No.:
APPLICATION FOR:
Associate Membership Full Membership
Registered Animal Specialist (RAS) / Registered Animal Product Specialist (RAPS)
Professional Animal Scientist (PAS)

Name: 
Institution/Company:  
Address:     
                  
City: State:
Zip: Country:
Phone: FAX:
E-mail:
Citizenship: 
Date of Birth:
AREA(s) OF SPECIALIZATION
(exam required in each area chosen)
1. Aquaculture 5. Horses 9. Swine
2. Beef Cattle 6. Laboratory Animals 10. Meat Science
3. Companion Animals 7. Poultry 11. Dairy Product Science
4. Dairy Cattle 8. Sheep and Goats 12. Poultry Products
FEE
  Application fee $85  
(non-refundable, pays first year dues and includes electronic version of journal)
  Optional fee  $35 (includes paper copy of the journal with membership)
(Make check payable to ARPAS)
Name to be printed on certificate:
I certify that the materials submitted in support of this application are true and correct to the best of my knowledge and that I will abide by the Code of Ethics.
Date:Applicant's signature:
"I believe this person has the necessary qualifications, would uphold the ideals of the Registry, and would abide by its Code of Ethics."
Name of ARPAS Member:Signature and Date:

Must also provide the information requested on the Background Information Required for Registration Application. 
Please call the ARPAS office at 217/356-5390 for assistance if the name of an ARPAS Member is unavailable to you.
AMERICAN REGISTRY OF PROFESSIONAL ANIMAL SCIENTISTS (ARPAS)
(Attach additional sheets if necessary)
1. Educational Background
Degree Date of Degree Major Area Institution

 
2. Experiences in Animal Science prior to obtaining last degree.

 
3. Positions since obtaining last degree.
Position Dates of Employment Responsibilities and Activities

 
4. Memberships in professional organizations.

 
5. Membership in honorary organizations.

 
6. Attach official transcripts of all academic credits (undergraduate and graduate).

Mail this form to:

ARPAS
1800 S. Oak Street, Suite 100
Champaign, Illinois 61820-6974
217/356-5390
FAX: 217/398-4119