DOGS Victoria
Locked Bag K9, Cranbourne 3977
Ph: (03) 9788 2506 Fax (03) 9788 2599
Applications close –
4pm Friday 7th August 2015
APPLICATION FORM
ENTRANCE THEORY EXAMINATION
Tuesday 15th September 2015
NAME:
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ADDRESS:
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EMAIL:
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(Home) ____________________________________
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VCA MEMBERSHIP NO: ________________________________________________________________________________
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I HAVE ATTENDED ALL ASPIRING LECTURES AND HAVE ATTACHED MY LECTURE
ATTENDANCE RECORD
I NEED ASSISTANCE BECAUSE OF A LEARNING DISABILITY
PLEASE ENCLOSE APPLICATION FEE $63.00
(Non-Refundable)
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DATE:________________________
APPLICATION WILL NOT BE ACCEPTED WITHOUT LODGEMENT FEE