A Day in Veterinary Medicine Registration Form

VMX and Blend Sponsor: A Day of Service - Believe and Belong in Veterinary Medicine January 16, 2023• 8:00 AM – 4:00 PM EST

Join us for a meet and greet with BLEND CEO, Dr. Niccole Bruno, panel discussions, Hands-on workshop stations and learn about scholarship opportunities and in-hospital shadowing. Hey Parents! Join us for a morning session to help prepare your kids for the road to vet school! (Limited to 1–2 adults/guardians per student.)

Instructions for Blend Registration Form:

Please enter your student's information first

If your student does not have an email, you can use a parent’s or school email address instead.
If you are not able to bring your student to the event, please give us both the name of an emergency contact and the information of the person who will bring your student

We will only release students to the listed accompanying adult on this form.
Parents and guardians are welcome to join us for a parents’ program but are not required to do so.

On the Review step, you will have the option to register for the Parent/Guardian program (this is not required)

Click “Add Parent/Guardian”
Add the Parent/Guardian information

More information:

You can register up to 2 parents/guardians per child

First Name	Given Name
Preferred First Name	Nickname (if different from First name)
Last Name	Family Name
Email	Your primary email address which will become your Login ID
Cell Phone	Work or Personal (preferred format xxx-xxx-xxxx)
City	City
State	State/Province State/Province