New South Wales Repealed Regulations

This legislation has been repealed.

VETERINARY SURGEONS REGULATION 1995 - SCHEDULE 4

SCHEDULE 4 – Forms

(Clause 32)

Form 1

Board of Veterinary Surgeons of New South Wales

FORM OF DECLARATION

I,
of

am an applicant for registration as a veterinary surgeon under the Veterinary Surgeons Act 1986 of New South Wales.

I declare that:

• I am of good reputation and character,

• I will pursue the work of my profession with diligence,

• in practising veterinary science, I will promote the welfare of animals,

• I will observe the veterinary surgeons code of professional conduct, and

• I will maintain a standard of professional knowledge and expertise at a level that is accepted by my professional colleagues who are of good standing.

Form 2

Board of Veterinary Surgeons of New South Wales

APPLICATION FOR FULL REGISTRATION

I,
of*

apply for registration under section 12 of the Veterinary Surgeons Act 1986 .

I declare that I am the person named in the documents accompanying this application as set out below.

* State your residential or business address (but not a post-office box number) if different from the above.

State below your postal address if it is different from the residential or business address you gave above.

The following documents must accompany your application:

• a declaration that you will uphold the veterinary surgeons’ code of professional conduct;

• your photograph (any size), which must be signed by you on the back;

• a copy of your birth registration certificate (or if it is not available, other evidence of your age acceptable to the Board-for example, a driver’s licence or passport);

• a copy of any academic award, certificate of registration or other document that provides evidence of your qualification for registration (or if you cannot produce such a document, any other evidence of your qualification, showing the qualification obtained and the date it was awarded);

• if you are relying on registration at a place outside New South Wales, you must provide a letter from the registering authority for that place certifying your registration and good standing;

• if you are an overseas graduate, you must provide evidence of your right to remain in Australia (for example, a certificate of Australian or New Zealand citizenship, a visa for permanent residency in Australia or a work visa for temporary residency in Australia).

Note: Section 58 of the Act provides a maximum penalty of $2,000 or 12 months’ imprisonment, or both, for persons who make false or misleading statements in or in connection with this application.

Form 3

Board of Veterinary Surgeons of New South Wales

CERTIFICATE OF REGISTRATION

This is to certify that
was registered as a veterinary surgeon under the Veterinary Surgeons Act 1986 onday of19

Form 4

Board of Veterinary Surgeons of New South Wales

CERTIFICATE OF LIMITED REGISTRATION

This is to certify that
ofwas onday of
19granted limited registration as a veterinary surgeon under section 14 of the Veterinary Surgeons Act 1986 for the purpose of

This certificate remains valid until19

The registration is subject to the following conditions:

1

2

3

4

Form 5

Board of Veterinary Surgeons of New South Wales

CERTIFICATE OF REGISTRATION AS A SPECIALIST

This is to certify that
was registered as a specialist veterinary surgeon in
under the Veterinary Surgeons Act 1986 onday of19