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General Information

U.S. Citizen? *
Residence Card or Student Visa? *

Education

Please provide a complete record of your undergraduate education, including MT/MLS training, as applicable. Any entry including the institution’s name requires all fields to be completed. Submit copies of all transcripts or transcript evaluations for with initial review packet.
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Work Experience

Please provide information on applicable work experience following completion of a baccalaureate degree
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Professional References

Please list two persons from whom you will request a professional reference from. All fields are required. 
1. 

2.
Please have two (2) letters of recommendation sent to: 
Bill Martinez
LifeSouth Community Blood Centers, Inc. 
4039 Newberry Rd.
Gainesville, FL 32607

Curriculum Vitae


Personal Statement

Please submit a personal statement (1-2 pages) that addresses the following topics:  
- What are your career goals?  
- Describe your professional strengths. 
- What experiences or qualities do you have that will help you succeed in a distance-learning program?
- Describe how you see this program affecting your life. 
- List any honors, awards, and activities that may be applicable, such as organization memberships, publications, and presenatations at seminars or meetings. 

SBB Applicant Experience Documentation


Agreement for SBB Student Mentoring


Facility Information


Facility Memo of Understanding