Radiation Protection Training

> Environmental Health and Safety > Programs and Services > Radiation Safety > Radiation Protection Training

University of Toronto
Radiation Protection Training Registration Form

Radiation Safety Training - no previous training; classroom setting
Administrative Training Only - for users trained outside U of T

Special Student Radiation Safety Training (Summer and Fall)

NON-UNIVERSITY OF TORONTO APPLICANTS:
Please contact Radiation Protection Services via email anna.mozharova@utoronto.ca

Page 1 of 1

IMPORTANT NOTE: A copy of this registration form will be sent to the e-mail address that you provide. You may assume that you have been approved to take this course unless notified otherwise. Should you have any questions, please contact: Anna Mozharova at 416-978-4467.

SECTION A

REGISTRANT'S INFORMATION - THIS INFORMATION IS REQUIRED FOR ALL COURSES.

Last Name:

First Name:

Department:

Telephone No:

Enter a valid phone number. Example: 123-456-7890

E-Mail Address:

Enter a valid email address. Example: name@company.com

UTORid:

Staff or Student No.

SECTION B

PRINCIPAL INVESTIGATOR'S INFORMATION - THIS INFORMATION IS REQUIRED FOR ALL COURSES.

PI Name, Permit No., E-Mail Address:

Your PI's e-mail address is required information; please enter it in the following field (the e-mail address is visible in the PI Name field once you have selected your PI).

PI E-Mail Address:

Enter a valid email address. Example: name@company.com

COURSES AND DATES: All training is done at 256 McCaul Street, Room 117

SECTION C

REGULAR RADIATION TRAINING - For attendees who have no previous training in the use of radioactive material. The course runs for two mornings from 9:00 a.m. to 1:00 p.m., and attendance on both days is mandatory. Training concludes with an exam at the end of the second day's lecture, and a follow-up will be done in the lab within a few days. Following this course, the successful applicant will be able to perform independent work with radioactive materials.

Date (Regular Radiation):

SECTION D

ADMINISTRATIVE ONLY - Offered to users previously trained outside the University of Toronto. Administrative training only plus exam, and a follow-up to be done in the lab within a few days. Following this course, the successful applicant will be able to perform independent work with radioactive materials.

Name of the institution where the training was completed: (Required)

Number of years experience: (Required)

Radioisotopes Handled:

Date (Administrative Only):

SECTION E

SUMMER/FALL SPECIAL STUDENTS TRAINING - Three hours in the classroom. No exam, no follow-up. Students must be supervised at all times in the lab.

Date (Special Students):

SECTION F

IN CLASS REFRESHER - Previous U of T training required. available only online.

Date (In-Class Refresh):

CONDITIONS of REGISTRATION
The department agrees to pay a charge of $50.00 if, for any reason other than illness, the registrant fails to attend the course without having given two working day's notice.

Radiation Protection Training

NON-UNIVERSITY OF TORONTO APPLICANTS: Please contact Radiation Protection Services via email anna.mozharova@utoronto.ca

NON-UNIVERSITY OF TORONTO APPLICANTS:
Please contact Radiation Protection Services via email anna.mozharova@utoronto.ca