VBM Certificate Application Business Certificate Application Form Please complete this application to be considered for acceptance into the Business Certificate Program at the University of Florida College of Veterinary Medicine. Good academic standing is required for enrollment and to remain in the certificate program. Academic standing will be monitored each semester. Date* Name* First Last UF Student ID Number (without dash)*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*2018201920202021Statement of Purpose*In 100-200 words, describe why you wish to obtain a business certificate as well as what you hope the training will help you accomplish in your career. Your statement of purpose, along with the photo, may be posted on our web site.Brief Bio*In 100-200 words please tell us a little about yourself. Include your relevant education, work, and volunteer history and anything else you wish to share. We will use this bio to accompany posters, presentations, and articles you publish while enrolled in the Business Certificate Program. Summer 2018 conflictsPlease share any scheduling conflicts or preferences you have identified for Summer 2018 clerkship blocks A-F. This information will be used to schedule your VEM 5894 required VBM clerkship. Photo*Please provide a recent photo of yourself, preferably with an animal!Accepted file types: jpg.Waiver* I understand that by checking this box and submitting this application I am authorizing the UF College of Veterinary Medicine Business Certificate Program to utilize my likeness, bio, and comments/reports to promote and publicize the UF College of Veterinary Medicine and the Business Certificate Program. CommentsThis field is for validation purposes and should be left unchanged.