American Veterinary Medical History Society (AVMHS)

J. Fred Smithcors
 Student Veterinary History Essay Contest
2010

ENTRY FORM

An entry form must accompany each submission.  Please do put your PERMANENT address, phone & e-mail since many of you may be moving on to jobs and internships before the decisions are made!

Fill in the blanks on this page and print it from your browser, or print out and fill in the form with a typewriter (or in block print).

NAME:

PAPER TITLE:

SCHOOL:

GRADUATION YEAR:

PERMANENT ADDRESS:

CITY:                                                                       

 STATE/PROVINCE:                                                  ZIP/POSTAL CODE:

PHONE NUMBER:

E-MAIL ADDRESS:

Mail or overnight delivery provider (postmarked by 1 April 2010) one printed copy of this form with five (5) copies of the essay to:

Russell W. Currier, DVM, MPH
Chair, AVMHS Vet History Essay Cmte

1864 NW 151 Court
Clive IA 50325 USA


In addition, please send one pdf version of your paper to Dr. Currier at ruscurrier@yahoo.com

Please note you must still send the 5 paper copies to the address above!