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APPLICATION FOR DIPLOMA REGISTRATION AS A …

80 The Terrace PO Box 11-905 T: 64 4 801 6250 Wellington 6011 Wellington, 6142 Page 1 of 2 APPLICATION FOR DIPLOMA ROUTE TO REGISTRATION AS A medical laboratory SCIENTIST TO BE COMPLETED BY THE APPLICANT My Name My REGISTRATION number 30-0 Email Address TO BE COMPLETED BY THE EMPLOYER Name of employer Name of supervisor REGISTRATION number 30-0 Position held TO BE COMPLETED BY THE UNIVERSITY (choose one option only) FOR OFFICE USE ONLY: I certify that (applicant name) is employed in the _____ department of this laboratory and has the support of this laboratory to undertake the practical component of the Graduate DIPLOMA in Science course of study leading to REGISTRATION as a medical laboratory scientist in New Zealand.

Diploma in Science (Medical Laboratory Science). OR . I certify that (applicant name) will be eligible to enrol in the Graduate Diploma in Science (Medical ...

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  Applications, Laboratory, Medical, Medical laboratory, Diploma, Application for diploma

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