Title:

Organization:

Activity:

Mailling Address:

City:

Country:

Work phone #:

Fax #:

Mobile #:

Email:

Personal Requirements

Dietary restriction:

Additional needs:

Hotel Accommodation?
I do need hotel accommodation
I do not need hotel accommodation

Arrival Date:

Depart Date:

Background Information

Please answer the following so that we can anticipate your current & future training needs:

Educational Back:

Educational Back:

Flow Cytometry Experience (answer by Yes or No):

If No please escape the following questions

If Yes please answer the following questions

Flow Cytometry Instrumentation?
less than year
from 1 to 3 years
from 3 to 5 years
more than 5 years

Name the machine you have:

Immunophenotyping Experience:

Sample Preparation?
less than 1 year
from 1 to 3 years
from 3 to 5 years
more than 5 years

Cytometer Setup?
less than 1 year
from 1 to 3 years
from 3 to 5 years
more than 5 years

Data Acquisition?
less than 1 year
from 1 to 3 years
from 3 to 5 years
more than 5 years

Data Analysis?
less than 1 year
from 1 to 3 years
from 3 to 5 years
more than 5 years

DNA Cell Cycle Analysis

Sample Preparation?
less than 1 year
from 1 to 3 years
from 3 to 5 years
more than 5 years

Cytometer Setup?
less than 1 year
from 1 to 3 years
from 3 to 5 years
more than 5 years

Data Acquisition?
less than 1 year
from 1 to 3 years
from 3 to 5 years
more than 5 years

Data Analysis?
less than 1 year
from 1 to 3 years
from 3 to 5 years
more than 5 years

Cell Sorting: Setup & Performance:

Sample Preparation?
less than 1 year
from 1 to 3 years
from 3 to 5 years
more than 5 years

Cytometer Setup?
less than 1 year
from 1 to 3 years
from 3 to 5 years
more than 5 years