THE CENTRAL VETERINARY SOCIETY (Central Division of the British Veterinary Association) To the Hon. Secretary.                                                            Date ...................................... I ............................................................................ (Qualifications .....................................)       Full name (Block Capitals) of ............................................................................................................................................       Full address (Block Capitals) desire to become a Fellow / Associate Fellow* of the above Society, and, if elected, I agree to be bound by the rules of the Society.  I am / am not a member of the British Veterinary Association. Proposer ....................................................... Seconder .......................................................   Signature ..................................................... *(N.B. - Fellows must be members of the Royal College of Veterinary Surgeons.)