Confirm an Olds College - Practicum Student


This form is to be used by Clinics that have already been contacted by a current Olds College Student for practicums.




Student Name*
Student Program Practicum Date*

Veterinary Practice Information

Address*
Have you hosted an AHT or VMR, Olds College student in the past?*
Type of practice*
Number of RVT's in practice*
Number of DVM's in practice*
Number of VMR's or Client Care Specialists in practice*
Evaluator Contact Name*
Communications with Olds COllege will go to this email address.
Name of Additional Mentor who will be working with student.
Name of Additional Mentor who will be working with student.
Is there potential for employment after the practicum?*

Freedom of Information and Protection of Privacy Act

Personal information that is collected on this form will only be used in accordance with freedom of information and protection of privacy act.