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Tennessee School of Equine Dentistry Application

 

Full Name
Business Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
Cell Phone
FAX
E-mail
Gender
Age
Date of Birth
Physical Condition
Spouse's Name
Emergency Contact
Emergency Contact Phone #
Allergies or Medical Problems (in case of emergency):

 
Number of years working with horses and types of horses:

 
Previous formal education and training:

 
Horse handling experience, courses, schools, etc:

 
Reasons for attending this course:

 
Two or more Professional references are required, one of which should be a veterinarian with whom you are affiliated, including address and phone:
(Equine dentists, veterinarians, horse trainers, farm owners, and or complementary therapists, etc.)

 

Once an applicant is approved, a deposit is required.
Please call the Tennessee School of Equine Dentistry for further information.

 

 

 

 

 

 

 

 

 

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Copyright © 2001 [OrganizationName]. All rights reserved.
Revised: 12/07/07.