Safety Rules And Regulations Employee Acknowledgement Form - Microfabrication Laboratory

Acknowledgement Form

By signing this form, I certify that I have read understand and agree to follow the safety

rules and regulations in the microfabrication laboratory safety manual. I also certify that I

have attended the cleanroom safety seminar and I am fully aware of the potential dangers

that related to toxic gases and chemicals that are being used and stored in the laboratory.

I also understand that violation of safety rules and regulations will disqualify me from

being a lab user.

User’s name: ____________________________Email:________________________

User’s Signature: ________________________Date:_________________________

PI’s Signature: _______________________________________________________

Account Number:

_________________________Expiration

date: ________________

Budget specialist’s name, email and phone number

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Parent category: Business