Aptitude Test for Cytotechnologists

Registration Form

Name:

 

Address (work):

 

email address:

 

Qualifications (with date):

 

Total number of slides screened:

 

Date employment in cytology commenced:

 

I apply to sit the Aptitude Test with (please select you chosen technology): Conventional smears / Surepath LBC or ThinPrep LBC

 

Signature:

 

Date:

 

This application must be approved by your head of Department
(as verification that the applicant fulfills the entry criteria):

 

Signature: Head of Department

 

Date:

 

The examination fee of is determined by the local hosts. Please check the amount with them and the include the appropriate fee with this form.

(registration form in DOC format)