Employment Verification Form

You must be employed by a state or local public crime laboratory to enroll in this program. Fields in italics are required
First Name:
Last Name:
Your Title:
Company / Agency:
Your E-Mail:
Phone:
FAX:
Street Address:

City:
State:	ZIP:

Supervisor's Name:
Supervisor's E-Mail:
Supervisor's Phone:

Comments:
	Submit


Once your employment is confirmed, you will receive an email with further instructions and a registration code. You may then use this registration code to enroll in any or all of the 13 core modules funded by NIJ under this grant. This project is supported under FY08 (NIJ – COPS DNA/Forensics) Pub. L. No. 110-‐161, 121 Stat. 1897, 1910; 28 USC 530C

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