Student Training Certification and Disposition to Safely Handle Radioactive Material
Name:______________________________ Age:____ Gender: __M __F
Class for which certification is required:_______________________Semester/Year_______
Isotopes to be used:_________________________________
By signing below I affirm that I have received training on the safe handling and use of radioactive isotopes. I understand that my participation in exercises utilizing radioactive material requires the highest levels of safety and that any breach of safe operating procedures on my part will result in my dismissal from said exercises. I affirm that I am not pregnant at this time and that if this disposition changes I am obliged to inform my instructor before further participation in exercises using radioactive materials.