The document is an application for clinical training programs at LSU, requesting information such as name, contact details, demographics, education history, program details, and an application fee. Applicants are asked to provide their name, address, phone numbers, email, gender, citizenship status, veterinary education details, any postgraduate degrees, the program and semester they are applying for, and a $50 application fee payment.

1. LSU Clinical Training Program Application
PLEASE PRINT
Program Applying for (circle one) PAVE ECFVG
Program Start Date Applying For (circle one) January May September
Applying for Program Beginning (Year )
If ECFVG – applying for 1 or 2 semester program? 1 semester 2 semesters
Last (Family) Name
First / Given Name
Address
Phone number (cell/mobile)
Phone number (home)
Alternate Phone number
Best time to call (U.S. Central time)
E-mail address
Sex Male Female
Do you have a US Social Security number? Yes No
Country of Birth
Date of Birth
Country of Citizenship
Current Visa Status (if not US citizen)
School of Veterinary Medicine Attended
Graduation Date
Post Graduate degrees:
Institution Attended
Date of Graduation
Institution Attended
Date of Graduation
Institution Attended
Date of Graduation
Application Fee:
Please make check for $50.00 payable to Veterinary Clinical Sciences