Special Species Symposium 2012
April 13 – 15, 2012
University of Pennsylvania School of Veterinary Medicine
Please mail completed registration forms and checks to:
Kristine Stellato
1921 Valley Drive
West Chester, PA 19382
The cost to attend lectures only is $60
The cost to attend lectures and wetlabs is $80
Please make checks payable to Special Species Symposium
First name:
Last name:
Full name (as you want it to appear on your nametag):
Email address:
Phone number:
Street address (line 1):
Street address (line 2):
City:
State:
Zip:
Will you be bringing a car?
☐ Yes
☐ No
Please list any special dietary needs:
Will you be attending the wine tasting event at 6pm on Friday, April 13?
☐ Yes
☐ No
Please check one:
☐ Veterinary student
☐ Veterinarian
☐ Veterinary technician/nurse
☐ Other
If you are a veterinary student, please complete page 2; if not please stop here!
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For veterinary students
School:
Graduation year:
Would you be interested in lodging with a University of Pennsylvania
veterinary student if space is available?
☐ Yes
☐ No
If yes, what gender do you identify as?
Do you prefer same-sex housing?
☐M
☐ Yes
Which night(s) do you need housing?
☐F
☐ Doesn’t matter
☐ Friday
☐ Saturday
If you are registering for wetlabs, please rank the labs in order of
preference (1 = most preferred, 12 = least preferred):
____ Exotic Emergency Procedures
____ Reptile Handling
____ Raptor Care and Maintenance Workshop
____ Ferret Adrenalectomy
____ Marine Mammal Necropsy
____ Diagnostic Imaging of Exotics
____ Philadelphia Zoo Tour
____ Common Fish Diagnostic Procedures
____ Turtle Management and Necropsy
____ Ferret & Rabbit Dentistry
____ Avian Critical Care
____ Rodent Necropsy
Thank you! We look forward to seeing you in Philadelphia!
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