Basic Rodent Biomethodology Registration Form — Institutional Animal Care and Use Committee

First Name

Last Name

UL Employee ID

Your E-Mail Address

Phone Number

Rodent Experience?

	Never Worked with Rodents	Some Experience with Rodents	Extensive Experience with Rodents
To help us prepare class materials, please choose the answer that best describes your level of previous rodent experience.

Indicate the species approved in your IACUC protocol(s) Contact the IACUC Office if you would like to schedule a Basic Techniques Course with any other species.

Mouse

Rats

Requested Date - Choose ONE The class is held at 10:00 AM or 1:00 PM and lasts approximately 2 hours. If current times do not work with your schedule please contact the IACUC Office, IACUC@louisville.edu.

IACUC Protocol Number(s) Your PI must submit a request to add you to a protocol before you can attend this class.

Methods of Euthanasia List the euthanasia methods utilized by your lab. If you are not performing euthanasia, state "N/A"

Other Comments