ࡱ> -/,7  bjbjUU "7|7|l  llll x2$ ==R(rT ƛldkh0yj<ljPRINT THE FOLLOWING INFORMATION: NAME_________________________ P.I.:_____________________ Tel. No.________________________ P.I. Ext._________________ Email address:__________________ Protocol No. _____________ REQUIREMENTS FOR WORKING WITH ANIMALS SIGN-OFF FORM Before being allowed to work with animals or have access to the animal rooms at TɫƵ you must complete the following: Submit the Health History form to, and get a clearance from, the Wellness and Counseling Center (Rm. MR-J15). Attend a Policy /Animal Facility Orientation (H.Acosta EX 8515) Attend a species specific wet-lab (if the have less than one years experience handling the specific species) (H.Acosta x 8515) Return this form to the Animal Care Facility at the Marshak Vivarium after obtaining all the necessary signatures. (Keep a copy for your records). Health History Form Approved:_____________________________Date:______ Signature, (M.D.) Print Name Policy/ Animal Facility Orientation Attended:________________Date__________ Mr. Harry Acosta Wet Lab Attended for __________________ Date:________________ Species ______________________________ Signature Trainer/Print Name Animal prerequisite form 6/15/05 '(%&   CJ j0JU 5CJ \CJ 5\ !"\]'()*(h}~ & F$a$ & F  9`ab     1h/ =!"#$h% iD@D Normal$CJOJQJ^J_HaJmH sH tH 8@8 Heading 1$$@&a$5\<A@< Default Paragraph Font6@6 Footnote TextCJaJ8&@8 Footnote ReferenceH*,B@, Body Text5\%!"\]'()*(h}~9`ab 0000000000000000 0 0 00000000000000000000000@0 0    .EG|]333333"\\((*&((7HJJTghh4:BY|!!%%>_aaEthelbC:\Documents and Settings\Ethel\Application Data\Microsoft\Word\AutoRecovery save of Document2.asdEthel_C:\Documents and Settings\Ethel\Desktop\New Folder\backup\Iacuc1\Prerequisite sign-off form.docEthel_C:\Documents and Settings\Ethel\Desktop\New Folder\backup\Iacuc1\Prerequisite sign-off form.docPereta Rodriguez!A:\Prerequisite sign-off form.docEthel_C:\Documents and Settings\Ethel\Desktop\New Folder\backup\Iacuc1\Prerequisite sign-off form.docEthel_C:\Documents and Settings\Ethel\Desktop\New Folder\backup\Iacuc1\Prerequisite sign-off form.docEthelqC:\Documents and Settings\Ethel\Desktop\New Folder\backup\Iacuc1\IACUC ORIENTATION\Prerequisite sign-off form.docEthelsC:\Documents and Settings\Ethel\Application Data\Microsoft\Word\AutoRecovery save of Prerequisite sign-off form.asdEthelqC:\Documents and Settings\Ethel\Desktop\New Folder\backup\Iacuc1\IACUC ORIENTATION\Prerequisite sign-off form.docacostadC:\Documents and Settings\tang\Desktop\IACUC\Iacuc1\IACUC ORIENTATION\Prerequisite sign-off form.docJv 5@Z+<(IpZp`p^p``OJPJQJ^Jo(- ^`OJQJo(o pp^p`OJQJo( @ @ ^@ `OJQJo( ^`OJQJo(o ^`OJQJo( ^`OJQJo( ^`OJQJo(o PP^P`OJQJo(h^`.h^`.hpLp^p`L.h@ @ ^@ `.h^`.hL^`L.h^`.h^`.hPLP^P`L.p`p^p``OJPJQJ^Jo(- ^`OJQJo(o   ^ `OJQJo(   ^ `OJQJo( xx^x`OJQJo(o HH^H`OJQJo( ^`OJQJo( ^`OJQJo(o ^`OJQJo(h ^`OJQJo(h^`.hpLp^p`L.h@ @ ^@ `.h^`.hL^`L.h^`.h^`.hPLP^P`L.+<J@p                                  @$$3$$P@UnknownGz Times New Roman5Symbol3& z Arial?5 z Courier New;Wingdings"qhl& ņ{f0!20$h 2Q PRINT THE FOLLOWING INFORMATION:EthelacostaOh+'0 , H T ` lx!PRINT THE FOLLOWING INFORMATION:rosRINEthelTHthetheNormalHacostaH4osMicrosoft Word 9.0 @q@bq@+dVp@ n0՜.+,0$ hp  TɫƵ $ !PRINT THE FOLLOWING INFORMATION: Title  !"#%&'()*+.Root Entry Fƛ01Table jWordDocument"SummaryInformation(DocumentSummaryInformation8$CompObjjObjectPoolƛƛ  FMicrosoft Word Document MSWordDocWord.Document.89q