Penn Foster Vet Tech Externship Site Pre-Approval Form
Please complete the form if you would like to submit a veterinary hospital for externship pre-approval. Once we receive the request form, we will send the externship site requirements to the person indicated as the site coordinator on the form to complete.
Name of Veterinary Hospital
*
Address of Veterinary Hospital
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number for Veterinary Hospital
*
Please enter a valid phone number.
Name of Site Coordinator (The Site Coordinator will have access to the Site's profile in ELMS by CORE to complete the site requirements and forms. The Site Coordinator can be a Hospital Manager, Veterinarian, Technician, or any other administrative person.)
*
First Name
Last Name
Email address of site coordinator
*
example@example.com
Confirm email address of site coordinator
*
example@example.com
Name of student wanting to use site (if none leave blank)
First Name
Last Name
Student ID of student wanting to use site (if none or unknown leave blank). We ask that you notify the student once your site has received it's pre-approval.
Submit
Should be Empty: