UIC INSTRUMENT TRAINING FORM

Date:  __________________________________

Trainee’s full name, printed:  ____________________________________________

Instrument:  _________________________________________________________

Email address:  _______________________________________________________

Telephone number:  ___________________________________________________

Laboratory room # and hall:  ____________________________________________

Academic major:  _____________________________________________________

Advisor’s name, printed:  _______________________________________________

Advisor’s signature:  ___________________________________________________

Advisor’s department:  _________________________________________________

Trainee’s academic background and experience with scientific instruments: 

____________________________________________________________________

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Purpose for learning to use the instrument:  _________________________________

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