3 PLEASE KEEP THIS PORTION FOR YOUR RECORDS DISSECTION

PLEASE PRINT THIS FORM AND TAKE A COPY TO
X PLEASE COMPLETE THE REQUIRED INFORMATION IN ADDITION THE
6 COVER SHEET (PLEASE USE THIS SHEET

ACC 4152 IMPAIRMENT ASSESSMENT (ACCREDITED EMPLOYER) REPORT PLEASE
Associate Application Form (please Print and Complete
BLACK HISTORY MONTH 2007 EVALUATION FORM PLEASE

DISSECTION OF THE UPPER EXTREMITY

3


PLEASE KEEP THIS PORTION FOR YOUR RECORDS


DISSECTION OF THE UPPER EXTREMITY


BIOLOGY 425/525

INSTRUCTOR: DR. LAURIE WILLIAMS-HOGARTH


MINIMESTER 2022

JANUARY 3-21


9:00 AM-12:00 PM AND 1:00-3:00 PM EACH DAY

(for approximately 10 days weather permitting)


PREREQUISITE:

HUMAN ANATOMY & PHYSIOLOGY I (BIOL221 & 221L)


Dissection of the Upper Extremity is the only human cadaver dissection course offered at Towson University. Enrollment is limited to twelve (12) students selected from the applicants. The application deadline is 3:00 PM Tuesday, November 23, 2021. Electronic applications, sent to Dr. Williams-Hogarth ([email protected]), are preferred over hard copies.


The applicants that are selected will be notified by email after 1:00P on Tuesday, November 30, 2021. The selected names will be given to Mrs. Grue, the Administrative Assistant. She will enroll the students in the class and then notify those enrolled students by email. The notified students must then go on-line and register for the class. Please do not ask the Administrative Assistants for information about chosen students until AFTER 1:00 PM on Tuesday, November 30, 2021.


Any selected student that has not registered for the class by 3:00pm on Monday, December 6, 2021 will have their spot reallocated.


PLEASE KEEP THIS PORTION FOR YOUR RECORDS


DISSECTION OF THE UPPER EXTREMITY

Turn this portion in (only) to apply by emailing [email protected]



Name & Student ID#___________________________________________________


Address________________________________________________________________


Telephone______________________________________________________________


Email address__________________________________________________________


Class standing (junior, senior, non-deg, etc.)____________________________


Grade point average____________________________________________________


Prerequisite course completed__________________________________________


Name of instructor in above course_____________________________________


Vocational objective____________________________________________________


Why do you wish to take this course, which involves techniques of dissection of the human cadaver?_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


CLIENT DETAILS FORM PLEASE COMPLETE THE INFORMATION
CREDIT APPLICATION – TRANSMISSION A PLEASE REFERENCE
DATE PLEASE FILL IN TO THE


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