MOSHER SCHOLARSHIP APPLICATION

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This scholarship is for a Veterinarian pursuing residency training in an accredited pathology program. Although preference is given to students with a New England background, this application is open to all enrolled in programs in the USA, Canada, or US territories. This is an annual award of $8,000.

Application deadline is February 1, 2026

This application requires a reference from a Veterinary School Official. You will need to provide VSTONE with the name and contact information of your chosen School Official.
This application also requires a reference from a Veterinarian in private/corporate practice or industry. You will need to provide VSTONE with the name and contact information of a Veterinarian in private practice who is familiar with you.
This application requires a signature from a Notary Public. More information can be found at the end of this application.

Date:

APPLICANT INFORMATION

Using Autofill is not recommended.

FULL NAME:

DATE OF BIRTH:

Use this format mm/dd/yyyy

PLACE OF BIRTH:

SOCIAL SECURITY NUMBER:

No dashes please

EMAIL ADDRESS:

Please check your spelling. We will use this email address to contact you regarding this application.

PLEASE INCLUDE A SECOND EMAIL ADDRESS BELOW IF THE PRIMARY ONE WILL NOT BE VALID AFTER GRADUATION:

SECOND EMAIL ADDRESS:

Please check your spelling. We will use this email address to contact you regarding this application.

PHONE NUMBERS:

CELL PHONE:

Please just enter numbers - no parentheses, no periods and no dashes.

PERMANENT HOME PHONE:

Please just enter numbers - no parentheses, no periods and no dashes.

PRESENT PHONE NUMBER:

Please just enter numbers - no parentheses, no periods and no dashes.

ADDRESSES

PRESENT ADDRESS:

Address Line 1

Address Line 2

City

State

Zip Code

PERMANENT LEGAL RESIDENCE:

Address Line 1

Address Line 2

City

State

Zip Code

This address may be different or the same as your present address and is required.

YEARS AT PERMANENT LEGAL ADDRESS:

EDUCATION

VETERINARY PATHOLOGY PROGRAM INSTITUTE:

YEARS OF MATRICULATION:

PROGRAM DIRECTOR:

First

Last

VETERINARY COLLEGE:

YEARS COMPLETED:

MONTH & YEAR OF GRADUATION:

CITY/TOWN:

STATE:

ZIP CODE:

UNDERGRADUATE SCHOOL:

YEAR GRADUATED:

CITY/TOWN:

STATE:

ZIP CODE:

HIGH SCHOOL:

YEAR GRADUATED:

CITY:

STATE:

ZIP CODE:

Have you ever been a legal resident of a New England State?

If yes, please list the state and dates you lived there below:

NEW ENGLAND STATE #1 AND DATES LIVED THERE:

NEW ENGLAND STATE #2 AND DATES LIVED THERE:

NEW ENGLAND STATE #3 AND DATES LIVED THERE:

REQUIREMENT: VETERINARY SCHOOL OFFICIAL'S CONTACT INFORMATION:

NAME OF SCHOOL:

SCHOOL OFFICIAL'S NAME:

Please provide the full name of a School Official we can contact to provide a letter in support of your application.

SCHOOL OFFICIAL'S TITLE:

SCHOOL OFFICIAL'S EMAIL ADDRESS:

SCHOOL OFFICIAL'S PHONE NUMBER:

Please just enter numbers - no parentheses, no periods and no dashes

TITLE: DATES PROGRAM

REQUIREMENT: VETERINARIAN IN PRIVATE/CORPORATE PRACTICE OR INDUSTRY'S CONTACT INFORMATION:

VETERINARIAN'S NAME:

Please provide the full name of a Veterinarian we can contact to provide a letter in support of your application.

VETERINARY PRACTICE NAME:

VETERINARIAN'S EMAIL ADDRESS:

VETERINARIAN'S PHONE NUMBER:

Please just enter numbers - no parentheses, no periods and no dashes

REQUIREMENT: YOU MUST HAVE THIS FORM NOTARIZED

VSTONE requires a Notary Public to witness your signature to confirm the information on this application is correct.

Once your application is received by VSTONE, a PDF of your application will be emailed to you. You will notice a last page has been added requiring your signature and a spot for the Notary Public's signature. DO NOT sign or date the page until you are in front of the Notary Public.

You can print the application and bring it to a Notary Public for signature. Once signed take a photo of the entire notarized page and email it to: dev@vstonefund.org.

Or you can find an online Notary Public. To use an online Notary Public you will need to use your cell phone and it's camera. You will receive the completed, notarized document as a secure, downloadable PDF file with an electronic seal. Email the form you receive to: dev@vstonefund.org.

Please preview the application by clicking Preview Application. This is your chance to review your responses to be sure your provided information is correct before clicking the SUBMIT button.

If you need to change anything please click Previous.