The Office of Student Services and Admissions
DVM EXTERNSHIP OPPORTUNITY FORM

TYPE OF PRACTICE:   

CONTACT PERSON:   

HOSPITAL/CLINIC NAME:   

ADDRESS:

Apt. No/ P.O. Box: 

CITY:   STATE: ZIP CODE: 

PHONE NUMBER: 

FAX NUMBER: 

E-MAIL ADDRESS: 

NUMBER OF VETERINARIANS: 

PRACTICE BREAKDOWN:
% Canine   % Feline   % Equine   % Exotic  
% Sheep   % Dairy   % Swine   % Beef  
% Other (please list)  
% Ambulatory   % Out-Patient  
# Exam Rooms   # Surgery Rooms  

ADDITIONAL COMMENTS ABOUT YOUR HOSPITAL/CLINIC:   

RESPONSIBILITIES OF EXTERN:   

TIME OF YEAR DESIRED:
FALL    SPRING    SUMMER    NO PREFERENCE

STIPEND:      HOUSING: 
HOURS:      TRAVEL: 

PREVIOUS EXTERNS FROM PURDUE (if applicable):   

ADDITIONAL COMMENTS:   

If you have any questions or concerns, please contact:
Student Services Office
Purdue University
School of Veterinary Medicine
625 Harrison Street
West Lafayette, IN 47907-2026
(765) 494-7609
Fax: (765) 496-2891
E-mail: stuserv@vet.purdue.edu