BELLARMINE UNIVERSITY

DEPARTMENT OF CHEMISTRY & PHYSICS

LABORATORY RULES AND REGULATIONS ACCEPTANCE FORM

My signature below indicates that I have read the CHEMISTRY

LABORATORY RULES AND REGULATIONS document,

have had the document explained to me by the lab instructor,

understand the document's contents, and will agree to abide by them.

I will sign both forms and return one to the laboratory manager

for filing in the departmental records and I will retain the other copy

for my own records.

My Name (print): _________________________________________

Signature:________________________________________________ Date:____________________

Course:___________________________________ Instructor:_______________________________

Revised: 1/15/02 GWLE