REGULAR GRADUATE SUMMER SESSION IN EPIDEMIOLOGY

MAY 11 1976 APPLICATION FOR ADMISSION

School of Public Health
Epidemiology

June 20-July 10, 1976

NOTE: PRINT USING INK

1. Name KEIKO YAMAGUCHI
First Middle Last

2. Exact Title Research Associate 3. Department Epidemiology Division

4. Employer National Cancer Center 5. Office Phone Japan 03-542-2511

6. Office Address 5-chome, Tsukiji, Chuo-ku, Tokyo, Japan, 104
No. Street City State Zip

7. Home Address 4-845-21 Kotsubo, Zushi, Kanagawa, Japan, 249
No. Street City State Zip

8. Home Phone Japan 0468-71-9450 9. Sex Female 10. Date of Birth July 11, 1947

11. Teaching Activities

School or Agency	Subject	Types of Students	Hours Per Year
Taguchi Gaku-en	Public Health	Dietitian	30 Hours

12. College, University, and Professional Education

School	Major	Degree	Year
Women's Nutrition College	Nutrition	Bachelor of Nutrition	1970
Women's Nutrition College Graduate School	Epidemiology	Master of Nutrition	1972

13. Professional Experience (Start with Present Position)

Employer	Position	Duty	No. of Years
National Cancer Center	Research Associate	Research	5 Years

14. Have you had any graduate level courses in statistics? Yes No

Course Title	Hours	School	Year Taken
Statistics	45 Hours	Women's Nutrition College Graduate School	1970
Fundamentals of Biostatistics	15 Hours	University of Minnesota	1973

15. Have you had any graduate level courses in epidemiology? Yes No

Course Title	Hours	School	Year Taken
Epidemiology	45 Hours	Women's Nutrition College Graduate School	1970
Fundamentals of Epidemiology	12 Hours	University of Minnesota	1973

OVER

Source: https://www.industrydocuments.ucsf.edu/docs/bppp0227