Individual First Time User Registration Form

Olympus Fluoview 100 confocal in the CMMC building
Only fill out after your lab has registered and received training

First name:^*

Name:^*

E-Mail:^*

Telephone:^*

Lab head:^*

Will receive instruction from:^*

Experience with fluorescence microscopy: Yes / No

Experience with confocal microscopy: Yes / No

If so, please add a short description of experience
(include which confocal was used):

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I hereby consent to the processing of my personal data for registration for the symposium. This consent can be revoked at any time. Further information can be found in the data protection declaration.