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Begin with Part I by entering your name, last four digits of your Social Security number, address, email address, and daytime telephone number. Ensure all information is accurate for verification purposes.
Proceed to Part II, which must be completed and signed by your immediate supervisor or laboratory management. They will verify your work experience and eligibility for certification.
In the employment section, provide the start and end dates of your employment along with the average hours worked per week. This information is crucial for establishing your qualifications.
Your supervisor should review and mark proficiency in each area listed (Blood Banking, Chemistry, etc.) based on their assessment of your skills under supervision.
Finally, ensure that your supervisor signs the form and includes their contact details. Don’t forget to attach a letter of authenticity printed on original letterhead.
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