Application for Shelter Medicine Certificate Maddie's® Certificate in Shelter Medicine Application Please complete the application to be considered for acceptance into the Certificate in Shelter Medicine program through Maddie's® Shelter Medicine Program at University of Florida. Good academic standing is required for enrollment and to remain in the certificate program. Academic standing will be monitored each semester. Date NameFirstLastUF Student ID# (without dash!)*Address*Street AddressAddress Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificStateZip CodePhone*Email*Class Year*20132014201520162017Personal Bio*In 100-200 words, describe why you wish to obtain a certificate in shelter medicine as well as what you hope the training will help you accomplish in your career. Your bio, along with the photo, will be posted on our website.Photo*Please provide a recent picture of yourself, preferrably with an animal! Tagged as: application, apply, course, credits, education, elective, Maddie's, Maddie's Fund, Maddie's® Shelter Medicine Externship Program, medicine, shelter, shelter medicine, training, transfer programs, veterinary skills, veterinary students