Residency Candidate Registration
General Information
Program Status
-- Select Status Type--
Diplomate
Affiliate
First Name
Last Name
Professional Designations
Contact Information
Mailing Address
City
State
Country
Postal Code
Personal Phone Number
Work Phone Number
Email Address
Password
Education
Veterinary School Attended
Include Graduation Year(s)
Current Veterinary Licenses To Practice
Include Location and Governing Body
Have You completed a residency with A Recognized Specialty College?
-- Select --
Yes
No
Do you have at least four (4) full-time equivalent years of focused patient-care experience (Resident working toward diplomate status) or a non-patient-care experience (Resident working toward Affiliate Member status) in nephrology and urology documented within 10 years of this registration?
-- Select --
Yes
No
Please upload any relevant documentation demonstrating your contribution to the promotion, direction and advancement of the specialty including, but not limited to, clinical effort, publications, teaching/mentoring, continuing education, and research.
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