Program Application

Now accepting Applications for Fall 2012

First Name:
Middle Initial:
Last Name:
Previous names on Record:
Mailing Address:
City:
State:
Zip:
Home Phone:
Work Phone:
Cell Phone:

Student ID Number (if available)
Emergency Contact Name and Telephone Number:

Email Address:

The following are the pre-enrollment requirements for admission to the Veterinary Technology Program:

High School Graduate (or equivalent)
Biology 400/310 or equivelant, with a grade of "C" or better
Chemistry 305/307 (2A) or equivalent, with a grade of "C" or better

NOTE: It is the applicant's responsibility to verify course equivalency by completing necessary paperwork through the Cosumnes River College Counseling Office. Each applicant must supply transcripts with his/her application. Do not mail your official transcripts until you have completed your prerequisite courses with a "C" or better. Please mail a copy of your transcripts to:

Cosumnes River College
Careers & Technology Division
ATTN: Denise Sailor
8401 Center Parkway
Sacramento, CA 95823

Please fill in the following information:

High School Graduation or GED Date:

Course	Equivalent Class (if applicable)	Semester Completed	College	Grade
Biology 400/310
Chemistry 307

Note: If you are currently enrolled in one or more of these courses, write: "in progress." If you anticipate taking one or more of these courses during summer semester, write: "Summer 2011."

Signature:

Date:

(Type your name in the box)

(Type the date)