Application for use of the BioCurrents Research Center

"Electricity is of two kinds, the positive and the negative. The difference is, I presume, that one comes a little more expensive, but is more durable; the other is a cheaper thing, but the moths get into it." -- A Manual of Education, Stephen Leacock

All scientists interested in visiting the Resource should complete this form and submit it electronically or mail it to the address below (attn: Peter J.S. Smith, Ph.D.) This information is an absolute necessity for the Center's annual report to the NIH. Visitors to the BRC have all the privileges of regular MBL visiting scientists who rent laboratory space. BRC visitors are not charged bench fees but must cover all consumable costs relevant to their research. The BRC provides laboratory space, rig access and technical support. Additional information can be acquired by phone (508-289-7283) or email (infobrc@mbl.edu).

**Please Note:
 There may be difficulties submitting this form from certain browsers and email programs. If you do not receive a confirmation from the BRC within 3 days, please send the below requested information directly to psmith@mbl.edu within an email message. Thank you.**

Section 1: Individual's Information

Full name:
FAX #:
Ed. Degrees:
E-mail:
St. Address or P.O. box:
Home Institution:
City:
Position:
State, Zip Code:
Funding Source:
Country:
P.I. on Grant:

Telephone:

Grant Number:

Proposed Dates:

Section 2: Purpose of Work

Please fill in the following fields:

Title of proposed work:

What are your overall research goals and and what are the specific aims?

What preliminary studies, if any, have been carried out with the Center?

What specific aims do you propose, using BRC facilities?

Describe the preparation:

Additional comments:

**Please Note: There may be difficulties subitting this form from certain browsers and email programs. If you do not receive a confirmation from the BRC within 3 days, please send the above requested information directly to psmith@mbl.edu within an email message. Thank you.**
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