Division of Environmental Health & Safety 4202 E. Fowler Ave., CRS 104 Tampa, FL 33620 Ph.: (813) 974-4036 Fax:(813) 974-9346 www.usf.edu\eh&s EH&S Training Request Form Instructions: Please fill out this form in its entirety and e-mail eh&s@usf.edu, fax (813)9749346, or send via campus mail to CRS 104. Please allow up to 5 business days for your request to be processed. You will receive an e-mail with instructions once you are registered. Online Training Classroom Training ☐ Lab Safety/Hazardous Waste Training ☐ Lab Safety/Hazardous Waste Training (initial training) (also includes Biomedical Waste Training) ☐Hazardous Waste Annual Refresher (required each year after initial training) Date of training:Click here to enter text. ☐Biomedical Waste Annual Refresher Please visit EH&S website for training dates (required each year after initial training ONLY if biomedical waste is produced in your lab) Name: Click here to enter text. Principal Investigator: Click here to enter text. College: Click here to enter text. Department: Click here to enter text. Phone # (Office): Click here to enter text. Campus: Click here to enter text. Phone # (Emergency): Click here to enter text. Phone # (Lab): Click here to enter text. Building/Room No. (s): Click here to enter text. E-mail Address: Click here to enter text. USF Net ID: Click here to enter text. USF U Number: Click here to enter text. Have you attended EH&S Lab Safety Training before? ☐ YES Date of Last Training: Click here to enter text. ☐ NO Office Use Only Recorded By: Date: