By submitting this form, I certify that the above information is complete and accurate. I acknowledge
that failure to disclose complete and accurate information may result in denial of admission or dismissal from the University.
I acknowledge that physical injury and deatdare risks inherent in the use of these facilities, and I assume all associated risks
and I agree not to claim against the University for those risks. I agree to hold the University of Washington harmless from any
and all injuries, damages and liabilities that may occur in the course of my visit, except for negligent acts or omissions of
the University or its employees, students or agents acting in the scope of their duties.
By submitting this form, I agree to follow all Environmental Healtdand Safety rules at the University of Washington.
These rules are explained in detail on the Laboratory Safety Checklist at EHS.
For a further explanation of each requirement click on the associated hot text on the Checklist. These requirements include Chemical Management, Standard Operating Procedures (SOP), and Personal Protective Equipment (PPE) for research done in my laboratory at FHL. I verify that I will follow all of the instructions on the Laboratory Safety Checklist while at FHL.
The University of Washington reaffirms its policy of equal
opportunity in education regardless of race, color, creed, religion,
national origin, sex, sexual orientation, age, marital status,
disability, or status as a disabled veteran or Vietnam era veteran
in accordance with University policy and applicable federal and
state statutes and regulations.