User Authorization Form

All users of the Bio-NMR Core must complete this form. You must read the rules of using Bio-NMR facility before submitting this form. If you have any questions regarding safety in the NMR facility, please contact the Harvard Environmental Health and Safety Office.

First Name *

Last Name *

E-mail *

Phone *

eCommons ID

If you have a eCommons ID please enter it here. If you do not have one, you will need to request access Here: https://ppms.us/harvard-hms-test/vdoc/?pf=1&docid=23

Affiliation Type *

Harvard University

DFCI

Outside Academical / Non-profit

Corporate

Harvard ID *

DFCI ID number *

Institution *

Department

Lab Head/PI *

Provide a brief description of the types of samples and experiments you will run. Please remember that you are required to run your own samples:*

Types of samples and experiments *

What NMR instruments you have used in the past (i.e. Varian, Bruker, etc.):*

What NMR instruments you have used: *

Do you need training above and beyond that which will be necessary to familiarize yourself with this particular instrument? Please do not select "yes" if you know how to run samples already, but simply need to know how this machine works. *

Do you need training? *

Yes

Are you aware of the rules and regulations for using the facility, including safety information? *

Do you know the rules? *

Yes

Financial Contact

Name *

E-mail *

Phone *

33-digit Billing Code *

Payment Number (Project/PO/Grant) *

PO Number *

Address to where invoice should be sent: *

Leave this field blank

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User Authorization Form

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