2022 Veterinary Technology & Assistants Application

EDUCATION

Starting with high school up to the veterinary school you currently attend.
High School *
Year of Graduation *
School of Veterinary Technology
Degree/Year of Graduation
School of Veterinary Assistant Program
Degree/Year of Graduation
Undergraduate
School of Veterinary Technology/Assistant Program:
Other
Degree/Year of Graduation

EXPENSES

Student's annual expenses. (Please give actual figures, not school-supplied statistics)
Tuition
Room
Board (Food Expense)
Books/supplies
Personal costs
Other
Total Annual Expenses For The Coming Year

STUDENT LIABILITIES

Include all previous educational loans; do not include anticipated loans.
Loan Type
Total Loan Amount
Loan Type
Total Loan Amount
Loan Type
Total Loan Amount
Total Educational Loans
Credit Card Debt
Other Debt
If other debt, please specify:
Total Liabilities
Special Circumstances
Are there any situations or circumstances that you wish the board to consider as they evaluate your application?

CHARACTER REFERENCES
a. Veterinary School Faculty Member

A letter of reference from a faculty member from your college of veterinary technology /assistants program is required to be filed with this application. This letter must be dated.
Name *
Phone *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
b. Veterinarian working in New Jersey

At least one letter of reference from a veterinarian, working in the State of New Jersey must be filed with the board with this application. This letter must be dated.
Name *
Phone *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
c. Optional (neighbor, clergy, undergraduate teacher)

A letter of reference from a non-veterinarian, though not required, would be helpful to the board. This letter must be dated.
Name
Phone
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
All reference letters should be sent by the writer directly to the NJVF.

Email info@njvma.org
Postal Address NJVF, 750 US Highway 202, Suite 200, Bridgewater, NJ 08807
Fax 908-450-1286

ADDITIONAL DOCUMENTATION
Note: This application must be verified by the school officials listed below. Your Student Affidavit and copies of the first two pages of last year’s Federal Income Tax Return must be submitted for the Committee's examination. If you are filing an extension for last year’s tax return you must submit a copy once you have filed.

Certificate of Academic Standing and Residence
File Upload

Cancel of

STUDENT AFFIDAVIT
I am currently a: *

Full-time Student Part-time Student
I have uploaded: *

Tax Returns Certification of Academic Standing
I have read carefully the questions in this application. Each answer as made herein is correct and complete to the best of my knowledge and belief. I have made no knowledgeable effort to supply any fraudulent or deceiving information in order to receive an education grant. I give the NJVF permission to receive and verify the information reported and the documentation presented in support of this application.
Print Name *
Signature *

Clear
Date *

Month Day Year
Should be Empty:

VETERINARY TECHNOLOGY & ASSISTANTS EDUCATION GRANT APPLICATION