ACVP-Recognized Student Pathology Club Annual Report

This form also serves as the application for the Pathology Club Travel Award. To be considered for funding, the annual report must be submitted by December 15.

Name of Person Submitting this Form:

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Position in Pathology Club:

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If other, please specify:

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Please download and complete the following forms to include in your application:

Blank W-9 (US) or Blank W-8 (International)

Wire transfer form

School

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If other, please specify:

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Faculty Advisor First Name:

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Faculty Advisor Last Name:

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Faculty Advisor Email:

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Faculty Advisor 2 First Name:

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Faculty Advisor 2 Last Name:

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Faculty Advisor 2 Email:

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Officer 1 First Name:

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Officer 1 Last Name:

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Officer 1 Email:

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Officer 1 Title:

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If other, please specify:

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Officer 2 First Name:

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Officer 2 Last Name:

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Officer 2 Email:

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Officer 2 Title:

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If other, please specify:

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Officer 3 First Name:

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Officer 3 Last Name:

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Officer 3 Email:

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Officer 3 Title:

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If other, please specify:

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Officer 4 First Name:

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Officer 4 Last Name:

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Officer 4 Email:

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Officer 4 Title:

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If other, please specify:

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Officer 5 First Name:

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Officer 5 Last Name:

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Officer 5 Email:

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If other, please specify:

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Officer 6 First Name:

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Officer 6 Last Name:

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Officer 6 Email:

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Officer 6 Title:

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If other, please specify:

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Number of Current Club Members:

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Number of Meetings:

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Number of Wet Labs:

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Number of Guest Speakers:

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Other Activities Not Listed Above:

Does your club receive financial support from your institution for travel to the meeting?

Yes

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Does your club fundraise to support student travel to the meeting?

Yes

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Number of members who attended this year's Annual Meeting:

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Number of members who attended the Veterinary Student Breakfast:

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Number Number of members who presented (poster or oral) at this year's Annual Meeting:

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Number of members who won poster awards:

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Rate the Poster Presentation experience for your members:

Very Meaningful Experience

Meaningful Experience

Not Meaningful Experience

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Rate the Veterinary Student Breakfast experience for your members:

Very Meaningful Experience

Meaningful Experience

Not Meaningful Experience

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Rate the Meet the Pathologists experience for your members:

Very Meaningful Experience

Meaningful Experience

Not Meaningful Experience

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Rate the Veterinary Student Resident Forum experience for your members:

Very Meaningful Experience

Meaningful Experience

Not Meaningful Experience

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Additional student feedback on the annual meeting:

Other Club Membership Statistics

Number of members receiving ACVP externship scholarship in this calendar year:

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Number of students who APPLIED to Anatomic Pathology training program (including accepted):

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Number of students ACCEPTED into an Anatomic Pathology training program:

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Number of students who APPLIED to a Clinical Pathology training program (including accepted):

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Number of students ACCEPTED into a Clinical Pathology training program:

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Number of students ACCEPTED into a training program that trains in both:

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If any of these answers need explanation, enter here:

Pathology Club Travel Award Requirements

Award requirements have been met:

Both must have been met.

This report was submitted by December 15.

At least one member attended the Veterinary Student Breakfast at the Annual Meeting.

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Additional Requirements:

At least 3 must have been met.

Held regular meetings (at least 2 this year).

Conducted at least one anatomic or clinical wet lab.

Hosted at least one pathologist guest speaker or speaker who presented on pathology.

At least one member attended this year's Annual Meeting.

At least one member presented at this year's Annual Meeting.

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Completed, Signed Tax Form

W9 or W8

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Completed Form or Payment Wire to Entity Bank Account

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ACVP-Recognized Student Pathology Club Annual Report

This form also serves as the application for the Pathology Club Travel Award. To be considered for funding, the annual report must be submitted by December 15.

Club Information

ACVP Annual Meeting

Other Club Membership Statistics

Pathology Club Travel Award Requirements

Documents