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#19-003121-0002
Supplemental Questionnaire

Last Name
First Name

 

***Please note that your answers on the supplemental questionnaire must correspond to the information provided on your application to receive credit. Applications that do not include a completed supplemental questionnaire will be considered incomplete and may be subject to disapproval.***


1.

Describe your experience in dissecting, preserving, processing and analyzing tissues samples for histology and microbiology. Please be specific. If you do not have any experience, answer N/A in the box below.

2.

Describe your experience in histology, microscopy, cell culture, bacteriology, virology and/or polymerase chain reaction (PCR). If you do not have any experience, answer N/A in the box below. 

3.

Describe your experience in preparing reagents and microbiological media. If you do not have any experience, answer N/A in the box below. 


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