RO4 Form
First Name  
Last Name  
Job Title  
Campus Key  
Campus Email  
Building  
Department  
Phone  
Lab Number  
Animal Housing Location(s)
 
     
Principal Investigator  
Species
 

1. Describe your academic training, credentials, (e.g. degrees, AALAS certifications) and previous experience in animal research activities.
Describe
   
  
 
 
   
   

2. Briefly describe your role in animal activities related to the protocol(s). Before submitting this form please verify the listed animal activities with your lab manager or PI to see if they are accurate.
   
Describe
   
  
 
 
   

3. It is required that you attend bio-techniques training with an LAS veterinary technician. Please indicate what animal procedures you will be performing and any other specific technical training you would like to receive.
Describe
   
  
 
 
   
   
Trainee Electronic Signature For Office Use Only
Please use your Campus Key as your Electronic Signature.