Core Facility - User Authorization Form : Institute for Applied Life Sciences : UMass Amherst

Please register here for the facilities that are listed in CORUM.

An Authorization Form must be on file with IALS before the use of research equipment.

If you don't have a UMass NetID account, please use the Core Facility - External User Account Request form.

Name of User *

Email Address *

UMass NetID *

UMass ID Number *

Phone

Organization / Institution / Company Name

Department

Other Department

Core Facility *

Please indicate all Core Facilities for which you would like to request the use of this Speed type.

Authorization Start Date *

Month

Day

Year

Name of Principal Investigator *

Email Address of Principal Investigator *

Speed Type #1 *

Please indicate the speed type that you would like charged for the use of IALS research equipment.

Speed Type #2

Enter additional speed types.

Speed Type #3

Speed Type #4

Speed Type #5

Speed Type #6

Business Manager

Enter contact details for your business manager, if someone other than PI assists in processing billing.

Business Manager Email

Business Manager Phone

Do you require training to use the facility? *

Yes

No

Have you participated in a UMass Lab Safety Course? *

Yes

No

The Institute for Applied Life Sciences will send invoices via email that will include all individuals and their usages of equipment. The invoice will include the total amount during that period to be charged to the speed type above. You will have 7 business days to respond if you prefer to use a different speed type for that month’s billing, otherwise, the speed type will be automatically charged.

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Core Facility - User Authorization Form

Institute for Applied Life Sciences