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2010-2011 Rotating Small Animal Internship Additional Application Form
MICHIGAN STATE UNIVERSITY
ADDITIONAL APPLICATION FORM
VIRMP ACCT # ________________
Thank you for applying to Michigan State University’s Small Animal Rotating Internship Program. The Internship Program supports MSU’s goal of attracting a cohort of students who have demonstrated academic excellence, show evidence of leadership potential and the capacity to make a distinctive professional or scholarly contribution, contribute to a diverse educational community as evidenced by personal history, experience and academic accomplishments, and the promotion of understanding amongst persons of different backgrounds and ideas.
Two rotating internship programs are available, each carrying the same clinical and educational experience, stipend, and period of award:
Rotating Internship in Small Animal Medicine/Surgery, General Program, recognizing academic achievement, leadership potential, capacity for contribution to the profession, and potential to contribute to a diverse educational community.
Rotating Internship in Small Animal Medicine/Surgery, CVM Enrichment Program, recognizing academic achievement, leadership potential, capacity for contribution to the profession, a demonstrated contribution to a diverse educational community, and a history of overcoming obstacles.
Applicants for all positions must be United States citizens or permanent residents of the United States (or US Territories). Candidates who meet all the goals of the Internship Program are encouraged to apply for both the General and Enrichment Internship positions. In accordance with state law, the selection process “shall not discriminate against, or grant preferential treatment to any individual or group on the basis of race, sex, color, ethnicity, or national origin”.
Please assist us by responding to the following questions:
1. Applicant's name __________________________________________________
2. (Optional) Personal characteristics that may contribute to a diverse educational community (as described above) include_____________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
3. (Optional) Race/Ethnicity: I identify as African American, Hispanic, Native American, Alaska Native, Asian, Native Hawaiian, or other Pacific Islander.
- Yes _____
- No _____
4. I am a United States (US) citizen.
- Yes _____
- No _____
5. I am a permanent resident of the US.
- Yes _____
- No _____
6. I would like to be considered for (check one):
- a. A Small Animal Rotating Internship -General Program (ONLY).
- b. A Small Animal Rotating Internship - CVM Enrichment Program (ONLY).
- c. General AND Enrichment Internship Programs. (BOTH)
If you have checked 6c above, you must submit to the Veterinary Internship and Residency Matching Program (VIRMP) a separate rank for each: one rank for the Small Animal Internship –General and one rank for the Small Animal Internship-CVM Enrichment Program.
Michigan State University offers a unique opportunity in its Internship Program, and we look forward to reviewing your application. Please be aware that to receive consideration, all the requirements for application as stated on the Veterinary Internship and Residency Matching Program (VIRMP) website and application forms (including class rank) must be met by the published deadlines. INCLUDE THIS FORM WITH YOUR APPLICATION PACKET TO MICHIGAN STATE UNIVERSITY.
Submission Deadline Date: December 7, 2009
Submit Additional Application Form to:
Internship Program
Department of Small Animal Clinical Sciences
D208 Veterinary Medical Center
Michigan State University
East Lansing, MI 48824-1314
