Registered Animal Technologist Application Form

Please complete this form to apply for Registration as a Registered Animal Technologist (RAnTech).

Please ensure you read the Guidance Notes carefully before completing this form.

1Personal Details > 2Qualifications > 3Sponsors > 4Payment/Submit > 5Review Your Entry
Personal Details

Please complete your personal details below
This information will be held and kept securely on the IAT Membership Database for as long as you remain a member.
Name Name Title First Last Suffix
Previous surname

if applicable
Declaration:
I give my consent for my name to be published on the IAT website and in IAT publications

Declaration:
I give my consent for my name to be published on the IAT website and in IAT publications Yes No
Date of Birth Date of Birth / DD / MM YYYY
IAT Membership Number
Establishment
Establishment Address Establishment Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Daytime Telephone

do not include spaces
Email

Registered Animal Technologist Application Form

Registered Animal Technologist Application Form

Personal Details