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This document is used to collect information about the sponsoring facility or organization for the MLT program, including contact details, laboratory capacity, and accreditation.
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How to fill out MLT PROGRAM AFFILIATE INFORMATION FORM

01
Obtain the MLT PROGRAM AFFILIATE INFORMATION FORM from the official website or your program coordinator.
02
Carefully read the instructions provided with the form to ensure understanding.
03
Fill out your personal details accurately, including your name, address, phone number, and email.
04
Provide any required identification numbers or references as specified in the form.
05
Complete the section regarding your educational background, listing relevant qualifications and institutions.
06
If applicable, include your professional experience in the designated section.
07
Review the form for any missing or incorrect information before submission.
08
Submit the completed form through the instructed method, whether online or via mail.

Who needs MLT PROGRAM AFFILIATE INFORMATION FORM?

01
Individuals wishing to join the MLT program as affiliates.
02
Healthcare professionals seeking to expand their qualifications.
03
Students currently enrolled in related health science programs.
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10 of P.D. No. 438. 1.1 Only examinees who obtained a general average rating of at least 70% but lower than 75% in the Board Licensure for Medical Technologists are qualified to apply for registration without examination as medical laboratory technician.
The Medical Laboratory Technology (MLT) Program of Maine was created as a collaborative effort between the University of Maine at Presque Isle (UMPI) and the University of Maine at Augusta (UMA) in cooperation with hospitals across the state that serve as clinical affiliates.
The Medical Laboratory Technology (MLT) Program of Maine was created as a collaborative effort between the University of Maine at Presque Isle (UMPI) and the University of Maine at Augusta (UMA) in cooperation with hospitals across the state that serve as clinical affiliates.

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The MLT PROGRAM AFFILIATE INFORMATION FORM is a document used by affiliates of the MLT program to provide essential information regarding their partnership and activities.
Affiliates who participate in the MLT program and are involved in promoting or contributing to the program's activities are required to file the MLT PROGRAM AFFILIATE INFORMATION FORM.
To fill out the MLT PROGRAM AFFILIATE INFORMATION FORM, affiliates must provide accurate and complete information as required on the form, including details about their organization, contact information, and any relevant program involvement.
The purpose of the MLT PROGRAM AFFILIATE INFORMATION FORM is to collect necessary information from affiliates to ensure compliance with program guidelines and to facilitate communication and coordination within the program.
The MLT PROGRAM AFFILIATE INFORMATION FORM must report information such as the affiliate's name, organization, contact details, nature of the affiliate's involvement with the MLT program, and any relevant activities or contributions.
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