Contact Form for Information about Shelter Medicine A variety of opportunities are available for all students at UFCVM, regardless of whether they enroll in the Certificate program. These include gaining an overview of opportunities in this emerging field, learning practical hands-on skills for managing healthy populations, developing tools for improving animal welfare and behavior, polishing spay/neuter abilities, or meeting veterinarians and thought leaders who are actively working in the field. Students are encouraged to sign up early to receive information about Shelter Medicine, even if they just want to explore the topic and are not planning to enroll in the full Certificate program. After signing up, students will receive announcements about Shelter Medicine scholarships, externship travel funds, and training opportunities. Students interested in earning the Certificate in Shelter Medicine should notify the Shelter Medicine Student Services Coordinator as early as possible. This assures students will receive the advising they need to plan for successful completion and for staff to track completion of certificate assignments. Date Name First Last Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Class Year*Select one2018201920202021Bio*In 100-200 words please tell us a bit about yourself. Include your relevant education, work, and volunteer history and anything else you wish to share.I Am Interested In(check all that apply) Announcements about externship travel funds, training opportunities, scholarships, and other news about Shelter Medicine at UF Learning more about earning the Certificate in Shelter Medicine PhotoPlease provide a recent picture of yourself, preferrably with an animal!Waiver* I understand that by checking this box and submitting this application I am authorizing Maddie's Shelter Medicine Program to utilize my likeness, bio, and comments/reports to promote and publicize the Shelter Medicine and Certificate Program.