CCEN Visitor Training Program Application
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Please enter the information indicated below.

First Name:
Last Name:
Job Title:
Company Name:
Work Phone:
Email Address:
emailaddress@xyz.com
City:
Country:

Please make sure all contact information above is correct before proceeding.
 
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What kind of facility do you work in?
Reference Lab
Hospital Laboratory
Academic Institution
Other  
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Which platform are you using?
Beckman Coulter
Becton Dickinson
Other  
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Please specify the number of colors used for the majority of flow assays.
 

50 characters left.
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What is the vendor support in your country regarding instrument optimization?
 

1000 characters left.
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What is the availability of antibodies and other flow cytometry reagents in your country?
 

1000 characters left.
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Please describe your position.
Technician, Clinical Scientist, or Technologist
Laboratory Supervisor
Medical Director (MD or PhD)
Other  
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Please describe the level of your experience. 
Never worked in a flow cytometry lab
Beginner (Less than 2 years of experience)
Intermediate (2-5 years of experience)
Advanced (More than 5 years of experience)
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Which types of assays are you currently performing? Please include past experience in the other field.
Leukemia/lymphoma
Lymphocyte Subset Analysis
Fetal Hgb
PNH Analysis
MRD
Other  
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Please provide a brief summary of the healthcare system in your country. 
 

1000 characters left.
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Which regional organizations do you have available for support in the field of flow cytometry?
 

1000 characters left.
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Please provide a link to the website of your facility and a link to your regional organization of support.
 

1000 characters left.
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Please check all areas you would like to receive training in:
Instrument Optimization
Antibodies, Panels Fluorochrome Selection
Practical QC
Flow Cytometry Templates
Specimen Preparation
Acquisition
Analysis and Interpretation
Reporting
Competency Assessments of Technologists
Other  

Please provide a short statement describing how participation in this program will enhance your training in clinical cytometry and how you will be able to share this training with your colleagues in your current lab.
 

1000 characters left.
Thank you for submitting an application for the CCEN Visitor Training Program.

Please contact info@cytoed.org with any questions.