Instructions for programs not participating in VIRMP are below.

1. Complete all information requested on this application. PLEASE NOTE : Foreign nationals must be eligible for a J1 visa with no bars or home country requirement.
2. Arrange to have an official transcript of your professional (veterinary) coursework sent to the House Officer Program Coordinator. (If from a foreign school, please provide an English translation).
3. A Curriculum Vitae is required.
4. Request references from at least three sources (written in English) but not more than four, two of whom must be your clinical instructors. We will not initiate requests for references. (Letters may be sent via email to dcgomez@ucdavis.edu)
5. THE DEADLINES FOR RECEIPT OF APPLICATION MATERIALS ARE AS FOLLOWS::

Clinical Pathology (TBA), Radiology (November 16, 2011), Ophthalmology (November 11, 2011), Lab Animal/Primate Medicine (October 15, 2011), CAHFS (see website). For all other programs, the application deadline is December 5, 2011.

Send residency application and all supporting materials to: Preferred Method - email all materials to: House Officer Program Coordinator (Please put name of program in subject line) or

by post to: Diana Gomez, VMTH, One Shields Ave., Davis, CA 956168747.

Dairy Production Medicine applications to: Staci Slaght, VMTRC, 18830 Road 112 Tulare, CA 93274 (559) 688-1731.

CAHFS Residencies: Administrative Office California Animal Health & Food Safety School of Veterinary Medicine Davis, CA 95616 Voice: (530) 752-8709 Fax: (530) 752-5680.

Laboratory Animal/Primate Medicine: Applicants interested in Laboratory Animal/Primate Medicine only should contact: Dr. Terry Hewett at CLAS or Dr. Kari Christe at CNPRC Laboratory Animal/Primate Medicine residency applicants will need to submit items 2-4 above and a Letter of Intent.

The beginning date of each program is August 1, 2012. Laboratory Animal/Primate Medicine is a 29 month program with start dates of December 1, and July 1.

• This form may also be used to apply for the residency positions that are being offered by the California Animal Health & Food Safety Laboratory System (CAHFS). Please submit applications and inquiries to the appropriate address/telephone number listed above.
• Behavior, Clinical Pathology, Dairy Production Medicine, Lab Animal/Primate Medicine, Ophthalmology, and Radiology do not participate in the matching program.
• Please consult the detailed residency description for further information regarding each program.
  

Application
(Complete application online, then print and email along with Letter of Intent and other requested documents)

The University of California, Davis and the Veterinary Medical Teaching Hospital are interested in candidates who are committed to the highest standards of scholarship and professional activities, and to the development of a campus climate that supports equality and diversity.

One copy of supporting documents must accompany each application form.

Program: SELECT ONE Behavior Clinical Pathology Dairy Production Medicine Lab Animal/Primate Medicine Ophthalmology Radiology

Application Date (MM/DD/YYYY):
Last (Family) Name:
First Name:
Middle Name(s)
Address
City:
State:
Postal Code:
Country:
E-Mail:
Telephone:
Cell Phone:
Fax:
School or Employment Address: (Please limit input to 5 rows of 50 characters each.)
School or Employment Telephone:
School or Employment Fax:	(All phone numbers must be applicable from December - March)

Veterinary Education
First Veterinary College College Name and Address: (Please limit input to 5 rows of 50 characters each.) Dates of Attendance (MM/DD/YYYY): From:    To: Degree(s) Obtained: Graduation Date: Grade Point Average: Grade Point Scale (5.0, 4.0, etc): Class Rank: Class Size:   Second Veterinary College (if applicable) College Name and Address: (Please limit input to 5 rows of 50 characters each.) Dates of Attendance (MM/DD/YYYY): From:    To: Degree(s) Obtained: Graduation Date: Grade Point Average: Grade Point Scale (5.0, 4.0, etc): Class Rank: Class Size:
Veterinary Practice Work Experience (since acceptance to veterinary school)
Employer's Name and Address: (Please limit input to 5 rows of 50 characters each.) Current or most recent position Dates of Employment: From:    To: Job Title and Duties: (Please limit input to 5 rows of 50 characters each.) Employer's Name and Address: (Please limit input to 5 rows of 50 characters each.) 2nd most recent position Dates of Employment: From:    To: Job Title and Duties: (Please limit input to 5 rows of 50 characters each.) Employer's Name and Address: (Please limit input to 5 rows of 50 characters each.) 3rd most recent position Dates of Employment: From:    To: Job Title and Duties: (Please limit input to 5 rows of 50 characters each.)
Honors and Awards (related to veterinary medicine)
Special Interests (related to veterinary medicine)
References
Reference 1 Name: Address: City, State, Postal Code, etc: Title: Work Phone: Reference 2 Name: Address: City, State, Postal Code, etc: Title: Work Phone: Reference 3 Name: Address: City, State, Postal Code, etc: Title: Work Phone: Reference 4 Name: Address: City, State, Postal Code, etc: Title: Work Phone:
Letter of Intent
Attach separate sheets on which you describe your professional goals and what you expect from an internship.
I hereby certify that these statements are true and correct to the best of my knowledge and that my misstatements will be cause for rejection of this application.
Signature Date