College of Veterinary Medicine: Cornell University

Summer Dairy Institute Application for 2013

Please Enter a valid Email Address:

First Name:		Last Name:		Middle Initial:
College Attended:		Gender	Male Female
Current Address:		Permanent Address:
Phone:(xxx-xxx-xxxx)
Country of citizenship:
Special Needs:
QMPS course - intent to enroll	Yes No

A. College/University Education

Institution	Dates Attended (mm/dd/yyyy)	Degree	Major	Date Received/Expected (mm/dd/yyyy)	Class Rank (If known)

B. Curriculum Vitae

Please provide the requested information as an attached document. This document should include, but not limited to, the following:

Academic and professional honors
Work expereience (paid and volunteer)
Publications and/or research experience (if applicable)
Personal interests and achievements
Externships
Relevant coursework

Add file:

C. Career Goals and Releveant Experience

Summarize the objectives of your educational program and your long-range
professional goals. Describe educational and personal experiences that you consider
relevant to your career goals. (Do not exceed one page). Please note that this program is
intended for individuals who aspire to careers that support the dairy industry.

Add file:

D. Reference Name/Institutions:

It is important that you select your references carefully. Your references should
be able to comment on your qualifications for a career in support of the dairy industry.
Please list as many as four individuals, their email address and telephone numbers.

Name	Email Address	Telephone Number
1.
2.
3.
4.

Completed Applications will be reviewed between October 1, 2012 and January 20, 2013.
Successful applicants will be notified by February 15, 2013.
A $200 deposit is due March 15, 2013.
The balance due, one half by June 20, 2013, and remaining, minus scholarships, by July 19, 2013.

If you choose to mail your application, please remit to:

Dr. Charles Nydam
Cornell University
College of Veterinary Medicine
C2 536 Clinical Programs Center
Ithaca, NY 14853-6401
TEL: (607) 253-3151
FAX: (607) 253-3701

If you choose to e-mail your application, please send as an attachment to:
E-MAIL: summerdairyinstitute@cornell.edu