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#20-001930-0001
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

Do you possess 60 credit hours from an accredited college or university including three (3) courses in chemistry or biology? If YES, please attach a transcript(s) to your application.

Yes No
2

Describe your work experience as a Laboratory Assistant or Technician.

This experience must also be included on your application (please include name of employer, job title, dates of employment and hours worked per week). If you do not possess this type of experience, please indicate N/A.


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