the+wildlife+society+5410+grosvenor+lane+bethesdamd+20814-219....doc

thewildlifesociety5410grosvenorlanebethesdamd20814-219...THEWILDLIFESOCIETY•5410GrosvenorLane•Bethesda,MD20814-2144•(301)897-9770•Fax(301)530-2471APPLICATIONFORCERTIFICATIONOFPROFESSIONALWILDLIFEBIOLOGISTSValidThruDecember31,2012INSTRUCTIONS::TheWildlifeSociety,5410GrosvenorLane,Bethesda,MD20814-2144,’sresponsibilitytoprovidefulldocumentationofeducationandprofessional-.(Seepages13and14fordetailedinstructions).NOTE:pletingthisapplication,pleasecarefullyreadtheProgramforCertificationofProfessionalWildlifeBiologists,validthruDecember31,2012,(Last)(First)(Middle)(Month/Day/Year)ADDRESS*E-MAIL()(City)(State/Province)(PostalCode)(Country)Thisaddressis:HomeWorkTELEPHONENUMBERHomeBusiness()()APPLICATIONFORCertifiedWildlifeBiologist2AssociateWildlifeBiologistCertifiedWildlifeBiologistpreviouslycertifiedasanAssociateWildlifeBiologistHaveyoueverappliedforcertificationasanAWB?YESNOorCWB?YESNOIfso,when?MONTH/YEARAWBSTATUSCONFERRED(ifapplicable)NameasissuedonAWBcertificate(ifapplicable)-YEARINSTITUTION(S).*munication,publications,andCertificationDatabase(onceconferred).4Applicant’PLETEDCOURSES:Listallcoursesintheirpropercategoryandwherecoursetitlesdonotdescribecontent,(donotattach).Inaddition,applicantsshouldprovidecatalogorownwordcoursedescription,immediatelybelowthecourselisting(donotattach),,itemB,,butnotduplicated,amongcategorieswhenacoursecoversmaterialinmorethan