Application For Kansas Veterinary License Page 4
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10STATE OF KANSAS
APPLICATION FOR EXAMINATION
CERTIFICATE OF MORAL CHARACTER
1. To be signed by a licensed veterinarian.
2. To be signed by a reputable business or professional person.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
1. I hereby certify that I am a licensed veterinarian in the State of ______________________,
my certificate number being__________________ and that I have been acquainted with
______________________________________ for ____________months/years and to the
(Applicant’s name)
best of my knowledge and belief, he/she is of good moral character and I hereby recommend
him/her as worthy to take the examination for which he/she is applying.
Name:__________________________________________________________________
(Printed)
(Signature)
Address:________________________________________________________________
City, State, Zip:___________________________________________________________
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
2. I hereby certify that I have been acquainted with _____________________________
(Applicant’s name)
for __________months/years and that to the best of my knowledge and belief, he/she is
of good moral character and (I) hereby recommend him/her as worthy to take the
examination for which he/she is applying.
Name:__________________________________________________________________
(Printed)
(Signature)
Address:________________________________________________________________
City, State, Zip:___________________________________________________________
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Return this completed form, the application with fee, and other required information to:
Kansas Board of Veterinary Examiners
PO Box 379
Wamego, Kansas 66547
Phone: 785-456-8781
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