Syracuse University’s

REGISTRATION OF CLASS 3a, CLASS 3b AND CLASS 4 LASERS


*Please complete the table below for registration of lasers that are new to the department. If multiple lasers are to be registered, please submit this form for each laser.

LASER SUPERVISOR:

DEPARTMENT:
     

LASER
TYPE*		 LASER CLASS WAVELENGTH MANUFACTURER* POWER SERIAL NUMBER BUILDING AND
ROOM NUMBER		 CONTACT
PERSON

*If "Other", then list in "Additional Comments."


ADDITIONAL COMMENTS:



For questions call: Rebecca Ponza at X-9133