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Certificate in Laboratory Animal Medicine REGISTRATION FORM Name: Dr._________________________________________________________ Address: ___________________________________________________________ City: ___________________________________________________________ State: ___________________________________________________________ Zip Code: ___________________________________________________________ Company: ___________________________________________________________ Certificate in Laboratory Animal Medicine Title/Position: ___________________________________________________________ Home: ( E-mail: ___________________________________________________________ )____________________________________________________ (required for the Introductory theory course) * A COPY OF YOUR CURRENT LICENSE IS REQUIRED AS PROOF OF ELIGIBILITY. Please indicate the course(s) you are registering for: c Introduction to Laboratory Animal Medicine - Theory$________________________ c Applied Laboratory Animal Medicine I $________________________ c Applied Laboratory Animal Medicine II $________________________ c Applied Laboratory Animal Medicine III $________________________ Total enclosed ($1248.75 U.S. per course) $________________________ Fees are charged in Canadian dollars equivalent to the US tuition fee. Paid by: c Cheque (payable to the University of Guelph) c MasterCard c VISA Card#______________________________________ Exp. Date:_ ___________________ Cardholder:_________________________________ 3-Digit Security Code:___________ Signature: ___________________________________________________________ University of Guelph I.D.# (if applicable)__________________________________________ PRIVACY: We are committed to protecting your privacy. The personal information collected on this form will be used for registration purposes, for creating learner profiles, and for sending you relevant Open Learning information we believe may be of interest to you. For further information or to find out how to opt out of receiving future Open Learning information, call us at 519-767-5000 or visit: www.open.uoguelph.ca/privacy Endorsed by the American Society of Laboratory Animal Practitioners. Open Learning and Educational Support Room 160 Johnston Hall, University of Guelph, Guelph Ontario Canada N1G 2W1 www.LAM.OpenEd.uoguelph.ca A certificate program designed to provide continuing education and applied training for licensed U.S. veterinarians working in the field of Laboratory Animal Medicine. WHAT WHO WHO WHY HOW Certificate in Laboratory Animal Medicine The Certificate in Laboratory Animal Medicine provides continuing education and applied training for licensed U.S. veterinarians employed in the field of laboratory animal medicine. The Certificate program is suitable for veterinarians with busy schedules, looking for a flexible professional development program, combining online education with short, intensive, applied courses. The Certificate program consists of four courses, totalling 160 hours of study. Introduction to Laboratory Animal Medicine –Theory, a self-study core course, is offered online via the World Wide Web. Applied Laboratory Animal Medicine I, II and III each consist of short, intensive, 1-week placements at regional training centers. Learners will spend 40 hours per week at these facilities acquiring specialized knowledge and skills. The regional training centers are Association for Assessment and Accreditation of Laboratory Animal Care (AAALAC) accredited facilities. Why the Certificate in Laboratory Animal Medicine? Veterinarians working in the field of Laboratory Animal Medicine need the necessary knowledge and skills to evaluate animal care and ethics protocols. Topics covered include an overview of research animal care and use in the USA, ethics of experimentation, animal models and alternatives, factors affecting research data, anesthesia, analgesia and euthanasia, microbiological quality control, zoonoses and biosafety. Program Cost The Certificate program is $4995.00 US excluding travel, meals and accommodations for the three applied modules. Payment can be made on a per module basis, at $1248.75 per module. Canc ellatio n P o l icy A refund, less a $125.00 administration fee will be issued provided written notification of withdrawal is received by the Open Learning and Educational Support at least seven calendar days prior to the start date of a module. No refunds will be issued after this date. Eligibility The online introductory module is open to veterinarians licensed in one U.S. state. The applied modules are open to veterinarians holding a valid license in one state in the U.S. and employed in Laboratory Animal Medicine. Please include a copy of pertinent documentation when you register for the courses as proof of eligibility. How to Register Register by mail, fax, phone or online: q By mail: Open Learning and Educational Support 160 Johnston Hall University of Guelph Guelph, ON CANADA N1G 2W1 % By web: www.lam.OpenEd.uoguelph.ca & By phone: 519-767-5000 ` By email: [email protected] v By fax: 519-767-1114 Skills acquired in each of the applied modules include animal handling, blood and sample collection, protocol review and the function of the Animal Care committee. This program is endorsed by the American Society of Laboratory Animal Practitioners. Modules - Introductory and Applied The Introductory online module is offered three times annually, in February, May and October. The online course can be completed at your own pace, but must be completed no later than nine weeks after commencement of the course offering. The three applied modules will be administered through Open Learning and Educational Support and the Academic Coordinator. The applied placements may be completed consecutively or scheduled throughout the year. The maximum time allowed to complete the Certificate is two years from the commencement of the first course. www.lam.OpenEd.uoguelph.ca