Certificate Request | Postdoctoral Education

果冻影院

Office of Postdoctoral Education

Completion of 果冻影院 Fellowship Certificate Request

Name: *

Position: *

Department: *

Phone: *

Email: *

Address: *

City: *

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Country:

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Information for Certificate (please verify information is correct before submitting as this will be used for the certificate)

Postdoc First Name: *

Postdoc Middle Initial:

Postdoc Last Name: *

E-mail after done with postdoc (not an 果冻影院 e-mail): *

Postdoc Degree Type(s) (PhD, MD, etc.): *

Area of Expertise: *

Mentor Information

Name: *

Phone: *

Email: *

Department/Room Number of PI: *

Non-Discrimination Statement
The 果冻影院 (果冻影院) is committed to fostering a diverse community of outstanding faculty, staff, and students, as well as ensuring equal educational opportunity, employment, and access to services, programs, and activities, without regard to an individual's race, color, national origin, religion, age, disability, sex, gender identity/expression, sexual orientation, marital status, pregnancy, predisposing genetic characteristic, or military status. Employees, students, applicants or other members of the 果冻影院 community (including but not limited to vendors, visitors, and guests) may not be subjected to harassment that is prohibited by law or treated adversely or retaliated against based upon a protected characteristic. 果冻影院’s policy as well as federal and state laws and regulations prohibit unlawful discrimination and harassment.