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#24-002837-0001
Supplemental Questionnaire

Last Name
First Name

 

***Please note that your answers on the supplemental questionnaire must correspond to the information provided on your application to receive credit.***


1.

Are you a Type 1 or Type 2 USDA Accredited Veterinarian? If yes please list your accreditation number in the box below. If no indicate N/A.

2.

Do you possess avian veterinary experience? Please describe these experiences below and for how long you did that type of work. If you do not have this experience, please put N/A.


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