Fillable RPR 2A Responsible Users Training Experience (Idaho State University)

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RPR 2A Responsible Users Training Experience (Idaho State University)

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RESPONSIBLE USER’S TRAINING & EXPERIENCE
(Please type or print legibly)
Last name:_________________________Initials:_________Soc. Sec. No:__________________
Training in Basic Radiation Sciences: Type & Hours of Training.
Formal Supervised
Courses On-the Job
Subjects Location & Dates (hours) (hours)
Nature of radiation
sources
Biological effects
& risk estimates
ALARA principle
& minimizing exposure
Correct use of
protective devices
Provisions of regulations
& licenses
Response to radiation
emergencies
Responsibilities & rights
of Radiation users
Experience in Using Radiation: List radiation sources used personally; list nuclides and quantities, description of
machines, dates and nature of each use. (Attach supplemental sheets if necessary.) For each location where experience
was obtained, complete on “REQUEST FOR TRAINING VERIFICATION” form (RPR 1C).
The information above is accurate and complete.
NOTICE: IT IS PERMISSIBLE TO SUBMIT A MODIFIED CURRICULUM VITAE
(CV) SHOWING EXPERIENCE WITH RADIOACTIVE MATERIALS OR
RADIATION PRODUCING MACHINES INTEAD OF THIS FORM.
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RPR 2A Responsible Users Training Experience (Idaho State University)

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Completed 21 July 2020

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