0 - Mycological Society of America

EMPLOYEE DATA FORM
MYCOLOGICAL SOCIETY OF AMERICA PLACEMENT SERVICE
Please type or print all entries clearly.
1. Record Number: (leave blank)
2. Name: last
first
initial
3. Department or Organization:
4. University or Street:
5. City:
6. State or Province (abbrev.):
7. Zip or Postal Code:
8. Country (abbrev. if >10 characters):
9. Phone Number:
10. Degree 1 (M.S. or B.S./B.A.), Year, Professor, Institution:
- - - - - - - - - - - --
11. Degree 2 (Ph.D.), Year, Professor, Institution:
12. Postdoctoral experience. Year, Professor, Institution:
13. Interests. Circle letters from the following:
A. Morphology B. Taxonomy C. Physiology
D. Cytology E. Biochemistry F. Cell Biology
6. Genetics H. Ecology I. Molecular Biology
J. Pathology K. Mycorrhizae L. Medical
M,N,O = other
14. Organisms of interest. Circle one or more letters from list:
A. Mycetozoa B. Zoosporic Fungi C. Zygomycetes
D. Ascomycetes E. Basidiomycetes F. Deuteromycetes
6. Trichomycetes H. Pathogenic Fungi I. General