Training Request Form: Physical Biochemistry Instrumentation Facility @ IUB

Instrumentation

Training Request Form

Name

Phone

Mailing Address

Instrument Desired for Training

Faculty Sponsor

Sponsor Email

Sponsor Phone

Billing Address

Account Number To Be Billed

Brief Description of Application

Sample Description

Safety Issues with Sample

Other Issues or Information

1. I hereby acknowledge that I have completely read and understood the terms and conditions set forth for instrument training, use, billing and reservations as stated in the Indiana University Physical Biochemistry Instrumentation Facility User's Guide.

2. I agree to abide by all rules, regulations and policies of the Indiana University Physical Biochemistry Instrumentation Facility as well as the directions of the Facility Manager, Director and Executive Committee.

3. I acknowledge that I will be held responsible for damages to any equipment or accessories falling under the governance of the Facility, and that all expenses related to repair or replacement of equipment will be provided by me or my Faculty Sponsor immediately.

Checking the box to the left constitutes an agreement that you understand and agree to items 1,2 and 3 above.

Training Request Form

PBIF Handbook

Instrumentation

Training Request Form