ECVS APPLICATION FORM  FOR REVIEW OF CREDENTIALS

Passport size photograph
Please send a digital 
photograph (high resolution)
The completed form has to be returned to the ECVS by 
the set deadline  (see www.ecvs.org) 
- otherwise the application cannot be considered for next examination

Application fee: 		€ 200.– Resident
€ 300.– Alternate Trainee
€ 100.– ACVS Diplomates

European College of Veterinary Surgeons ECVS 
VetSuisse Faculty University Zurich
Winterthurerstrasse 260
CH-8057 Zurich, Switzerland
Phone:	+41-44-635 8408	e-mail: ecvs@vetclinics.uzh.ch
Fax: 	+41-44-313 0384	www.ecvs.org

 Name:
 First name:
 Date and place of birth:

 Veterinary  Degree / Date granted:
 Granting University / Country:
 License to practice in Europe: Country:				Date granted:

Business Address

 Zip code / City / Country:
 Phone:							Fax:
 E-mail address:

Home address
 Street:

 Postal Zip code / City / Country:
 Phone:							Fax:

Supervisor
Name / First name / Title:
 University / Practice:

 Address:
 City / Country:
 Phone:						Fax:
 Email:

Referee 1
Name / First name / Title:
 University / Practice:
 Address:
 City / Country:
 Phone:						Fax:
 Email:

Referee 2
Name / First name / Title:
 University / Practice:
 Address:
 City / Country:
 Phone:						Fax:
 Email:

It is the applicant's responsibility to make sure that the complete application and all the letters of reference are at the ECVS Secretariat in Zürich, Switzerland by the deadline of credentials submission. (submitted as original paper file together with an electronic version (pdf) of all documents.)

Date				Signature

	Evaluation form (covering form of the complete credentials file)
	Application form for review of credentials
	College Diploma/licence to practice in Europe
	Proof/verification of fulfilled internship / equivalent
	Programme supervisor statement
	Curriculum vitae
	Programme log summary
	Surgery Case Log
	Activity Log
	Documentation of specialty training in Anaesthesiology/Diagnostic Imaging/Pathology/Internal Medicine
	Presentation Log
	Accepted first authored paper 
	Accepted paper / case report
	Total of 3 letters of reference have to be mailed separately (referees should not be from the same institution)
	Payment of evaluation fee (see separate form on www.ecvs.org)

09/2007
REVISED 02/2010