OCEM Project Registration For External Users

Every user MUST have completed this form and have their project approved BEFORE use of equipment can commence. Failure to do so may make you liable for any damages caused during unauthorised use.

USER DETAILS
Name * First Last
Affilliation
Email
Work Phone Number
Mobile Phone Number
Postal Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
PROJECT DETAILS
Anticipated Start Date * / DD / MM YYYY
Anticipated End Date / DD / MM YYYY
Technique(s) Required *
Transmission Electron Microscopy Scanning Electron Microscopy Specimen Preparation Laboratory Ultramicrotomy Sectioning Liquid Nitrogen Supply
Brief Description of Project

This information is used when making bids for equipment funding and is very important. Please take the time to describe your project clearly and concisely.
Project discussed with the following OCEM staff member(s) prior to registering: *
Allan Mitchell Richard Easingwood Liz Girvan Gillian Grayston Sharon Lequeux Kat Lilly
ACCOUNT DETAILS
Purchase Order Number
Will you be collaborating with a staff member of the University of Otago and using a University account code? *
Yes No
University of Otago Account Code
HEALTH AND SAFETY
Will the specimen(s) require PC2 containment? *
Yes No
If your sample requires PC2 containment please include why (is the sample considered a risk good, animal cell culture, new organism, GMO, unwanted organism or an uncleared biological product?).
Will you be working on site at the OCEM? *
Yes No
If you will be working on site in the OCEM, please list any relevant allergies (e.g. latex gloves).
Additional Information
TERMS AND CONDITIONS OF USE
I have read and agree to the OCEM User Policy (http://ocem.otago.ac.nz/policyocem.html) *
Yes

OCEM Project Registration For External Users

OCEM Project Registration For External Users

USER DETAILS

PROJECT DETAILS

ACCOUNT DETAILS

HEALTH AND SAFETY

TERMS AND CONDITIONS OF USE