Heartland Veterinary Hospital

Please note: This is an unpaid educational opportunity. Submission of this application does not guarantee placement.

Applicant Information

Full Name:

Date of Birth:

Email Address:

Phone Number:

Emergency Contact

Emergency Contact Name:

Relationship:

Emergency Contact Phone Number:

Education Information

College / University Name:

Program Type:

Veterinary Technician Program

Veterinary School (DVM)

Other…

Degree or Certification Being Pursued:

Expected Graduation Date:

Are you currently enrolled in this program?

Yes

Internship Details

Is this experience required for your program?

Yes

If yes, how many hours are required?

Deadline to complete hours (if applicable)

Availability

Desired start date:

Desired end date (or estimated length of time):

Available days of the week:

Available times of day:

Experience & Interest

What do you hope to gain from an internship at Heartland Veterinary Hospital?

Additional Information (Optional but Recommended)

Upload Resume (PDF preferred)

One file only.
100 MB limit.
Allowed types: pdf, doc, docx, jpg, jpeg, png.

Upload School Documentation or Requirements (if applicable)

One file only.
100 MB limit.
Allowed types: pdf, doc, docx, jpg, jpeg, png.

Acknowledgments & Agreement

Please review and acknowledge the following:

I understand this is an unpaid educational opportunity

I understand placement is not guaranteed

I understand that if selected, I may be required to complete additional paperwork prior to starting

I agree to follow clinic policies, confidentiality guidelines, and supervision requirements while on site

Signature (Full Name):

Sign above

Date:

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College Internship Application