Application for Examination
Please read the following language in its entirety. This electronic acceptance will be legally binding. This question is required.
I HEREBY APPLY to the American College of Veterinary Behaviorists for the examination in accordance with its rules and herewith enclose the application fee. I also hereby agree that prior to or subsequent to my examination, the Board of Regents may investigate my standing as a veterinarian, including my reputation for complying with the standards of ethics of the profession. I agree that no fee paid by me shall be refundable to me except if and as may be expressly provided by the ACVB Constitution, By-Laws, or policy. I further covenant and agree 1) to indemnify and hold harmless the American College of Veterinary Behaviorists and each and all of its members, trustees, officers, examiners, and agents from and against any liability whatsoever in respect of any act or omission in connection with this application, such examination, the grades upon such examination and/or the granting or issuance of or failure to grant or issue a Certification to me, and 2) that any Certificate, which may be granted and issued to me shall be and remain the property of the American College of Veterinary Behaviorists. In support of this application, I make the statements hereinafter set forth each of which I warrant is true and correct.
Acceptance of above statement
First Name
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Last Name
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Complete WORK address. This question is required.
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Complete HOME address. This question is required.
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Daytime Phone Number. This question is required.
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E-Mail Address. This question is required.
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College and Year of Veterinary Graduation. This question is required.
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States and/or Countries Where Licensed to Practice. This question is required.
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Current AVMA Membership Number. This question is required. *If you do not have an AVMA Membership Number, please enter 'Not Applicable'.
Your answer
If the primary country of employment is not the United States, are you a current member of your country's national veterinary association? If the primary country of employment is not the United States, are you a current member of your country's national veterinary association? (Only required for those practicing outside of the United States. All those practicing in the United States may skip this question).
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List all publications (including those accepted for publication) that relate to the Specialty of Veterinary Behavior and in which you were first author. Upload one electronic copy of each of those publications next. This question is required.
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Upload one electronic copy of all first-author publications listed immediately before. This question is required.
List any publications in which you were not the first author.
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List four (4) veterinarians and/or other board-certified veterinary specialists with whom you maintain communication for the purpose of consultation in developing your expertise. Indicate the nature of the consultation, such as regarding diagnosis or patient care, or research. This question is required.
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Please list the names and addresses of three (3) to five (5) professional colleagues who will be providing evaluations on your behalf. At least one evaluator must be board certified by the ACVB. (Their completed Applicant Evaluation Forms should be sent electronically by the evaluator directly to the Executive Director of the American College of Veterinary Behaviorists as indicated on the form.) This question is required.
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