ASRC Facility New User Application

Name*
Institution/Affiliation*
User Type*
Keratin
Requesting user access to the following ASRC facilities:*
Type of Access Requested:*

*Rodent Behavioral Analysis Suite: 

For consultation on experimental design and instrument capabilities, please contact Facility Director Dr. Jia Liu (jliu1@gc.cuny.edu), or call 212.413.3183.

*Comparative Medicine Unit: 

For access to the CMU, please contact Lesley Picolli (lpicolli@gc.cuny.edu) and Isela Lopez (ilopez@gc.cuny.edu)


ASRC Facility User Agreements

ALCIS Access

All access requests must be emailed and discussed with Brian Giebel (ALCIS Core Director) before user onboarding can be completed. Please email Brian Giebel directly at bgiebel@gc.cuny.edu before proceeding with this application.

Surface Science Suite Access

All access requests must be emailed and discussed with Tai-De Li (Surface Science facility manager) before user onboarding can be completed. Please email Tai-De Li directly at tli@gc.cuny.edu before proceeding with this application.

Crystallography Access

All access requests must be emailed and discussed with Eta Isiorho (Crystallography Facility Manager) before user onboarding can be completed. Please email Eta Isiorho directly at eisiorho@gc.cuny.edu before proceeding with this application.

Have you received approval from Brian Giebel to proceed with your user application? *
Have you received approval from Tai-De Li to proceed with your user application?*
Have you received approval from Eta Isiorho to proceed with your user application? *

Before you proceed with your ASRC Facility User application, the following documents need to be completed and submitted:


ASRC Instrument Use Agreement (non-CUNY academic users)



ASRC Instrument Use Agreement (non-CUNY Industry/Non-profit users)



Nanofab Exhibit A Addendum (Research Service)

Epigenetics Exhibit A Addendum (Research Service)

 Imaging Exhibit A Addendum (Research Service)

 Live Imaging Exhibit A Addendum (Research Service)

NMR Exhibit A Addendum (Research Service)

MRI Exhibit A Addendum (Research Service)

RF/mm Exhibit A Addendum (Research Service)

Your institution already has a master agreement in place with the ASRC Core Facilities. 



INSTRUCTIONS - HOW TO COMPLETE



EQUIPMENT / INSTRUMENTATION USE TERMS & CONDITIONS - ASRC and GC Users: 

1. Provide a copy of the 'EQUIPMENT / INSTRUMENTATION USE TERMS & CONDITIONSto your Principle Investigator (PI)

2. The PI should complete the missing information on the document and sign. 

NOTE: your PI only has to complete one EQUIPMENT / INSTRUMENTATION USE TERMS & CONDITIONS. 



MASTER Facility Use Agreement - CUNY Users: 

1. Please provide the MASTER Facility Use Agreement to an authorized signatory at your College. Note: this is NOT your Principle investigator. 

2. Authorized signatory should complete blanks

3. If changes to the terms are to be requested, the authorized signatory may make these keeping track changes on in the document, and return the edited document to mhauber@gc.cuny.edu for negotiation. 

4. When terms are agreed, your authorized signatory may sign the agreement for upload.



MASTER Facility Use Agreement - non-CUNY Users: 

1. Please provide the MASTER Facility Use Agreement to an authorized signatory at your Institution or Company. Note for academic institutions: This is typically NOT the principle investigator.

2. Authorized signatory should complete blanks

3. If changes to the terms are to be requested, the authorized signatory may make these keeping track changes on in the document, and return the edited document to mhauber@gc.cuny.edu for negotiation. 

4. When terms are agreed, your authorized signatory may sign the agreement for upload.



MASTER Facility Use Agreement - non-CUNY Users: 

1. Please provide the MASTER Facility Use Agreement to an authorized signatory at your Institution or Company. Note for academic institutions: This is typically NOT the principle investigator.

2. Authorized signatory should complete blanks

3. If changes to the terms are to be requested, the authorized signatory may make these keeping track changes on in the document, and return the edited document to mhauber@gc.cuny.edu for negotiation. 

4. When terms are agreed, your authorized signatory may sign the agreement for upload.



MASTER Research Service Agreement: 

1. Please provide the MASTER Facility Use Agreement to an authorized signatory at your Institution or Company. Note for academic institutions: This is typically NOT the principle investigator.

2. Authorized signatory should complete blanks

3. If changes to the terms are to be requested, the authorized signatory may make these keeping track changes on in the document, and return the edited document to mhauber@gc.cuny.edu for negotiation. 

4. When terms are agreed, your authorized signatory may sign the agreement for upload.



Exhibit A Addendum

1. The Principle Investigator or Lead Scientist should complete blanks the Exhibit A Addendum(s)

2. The Principle Investigator or Lead Scientist must include the researcher(s) authorized to generate charges which will be invoiced to that PI/Lead Scientist. 

3. The researcher should also sign to acknowledge they are authorized to sign. 




Exhibit A Addendum (Research Service)

1. The Principle Investigator or Lead Scientist should complete blanks the Exhibit A Addendum(s)

2. The Principle Investigator or Lead Scientist should include a Statement of Work in the 'II. Statement of Work' section, including details of service required, equipment usage, schedule (number of samples), a reasonable timetable as agreed with the core facility director, and any special handling requirements. If you are unsure, please speak with the core facility director to confirm details. 

3. The researcher should also sign to acknowledge they are authorized to sign. 





NOTICES 


To discuss bulk rates for high volume usage, please discuss directly the Core Facility Director.



Have all forms been completed and signed? *
Signed - Master ASRC Facility Use Agreement (CUNY Users)*
No File Chosen
File uploads may not work on some mobile devices.
Signed - Core Facility Equipment and Instrument Use T&C's (ASRC Users)*
No File Chosen
File uploads may not work on some mobile devices.
Signed - Core Facility Equipment and Instrument Use T&C's (GC Users)*
No File Chosen
File uploads may not work on some mobile devices.
Signed - ASRC Instrument Use Agreement (non-CUNY academic users)*
No File Chosen
File uploads may not work on some mobile devices.
Signed - ASRC Master Research Service Agreement (non-CUNY academic users)*
No File Chosen
File uploads may not work on some mobile devices.
Signed - ASRC Master Research Service Agreement (CUNY users)*
No File Chosen
File uploads may not work on some mobile devices.
Signed - ASRC Instrument Use Agreement (non-CUNY Industry/non-profit users)*
No File Chosen
File uploads may not work on some mobile devices.
Signed - ASRC Master Research Service Agreement (non-CUNY Industry/Non-Profit users)*
No File Chosen
File uploads may not work on some mobile devices.
Signed -EXHIBIT A ADDENDUM - Nanofab*
No File Chosen
File uploads may not work on some mobile devices.
Signed- EXHIBIT A ADDENDUM - Nanofab*
No File Chosen
File uploads may not work on some mobile devices.
Signed- EXHIBIT A ADDENDUM - Crystallography*
No File Chosen
File uploads may not work on some mobile devices.
Signed -EXHIBIT A ADDENDUM - Crystallography*
No File Chosen
File uploads may not work on some mobile devices.
Signed - EXHIBIT A ADDENDUM - Imaging*
No File Chosen
File uploads may not work on some mobile devices.
Signed - EXHIBIT A ADDENDUM - Imaging *
No File Chosen
File uploads may not work on some mobile devices.
Signed - EXHIBIT A ADDENDUM - Surface Science*
No File Chosen
File uploads may not work on some mobile devices.
Signed - EXHIBIT A ADDENDUM - Surface Science*
No File Chosen
File uploads may not work on some mobile devices.
Signed - EXHIBIT A ADDENDUM -NGENS*
No File Chosen
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Signed - EXHIBIT A ADDENDUM -NGENS*
No File Chosen
File uploads may not work on some mobile devices.
Signed - EXHIBIT A ADDENDUM - NMR*
No File Chosen
File uploads may not work on some mobile devices.
Signed - EXHIBIT A ADDENDUM - NMR*
No File Chosen
File uploads may not work on some mobile devices.
Signed - EXHIBIT A ADDENDUM - Live Imaging*
No File Chosen
File uploads may not work on some mobile devices.
Signed - EXHIBIT A ADDENDUM - Live Imaging *
No File Chosen
File uploads may not work on some mobile devices.
Signed - EXHIBIT A ADDENDUM - Epigenetics*
No File Chosen
File uploads may not work on some mobile devices.
Signed - EXHIBIT A ADDENDUM - Epigenetics*
No File Chosen
File uploads may not work on some mobile devices.
Signed - EXHIBIT A ADDENDUM - Nanophotonics*
No File Chosen
File uploads may not work on some mobile devices.
Signed - EXHIBIT A ADDENDUM - Nanophotonics *
No File Chosen
File uploads may not work on some mobile devices.
Signed - EXHIBIT A ADDENDUM - MRI*
No File Chosen
File uploads may not work on some mobile devices.
Signed - EXHIBIT A ADDENDUM - MRI*
No File Chosen
File uploads may not work on some mobile devices.
Signed - EXHIBIT A ADDENDUM - MS*
No File Chosen
File uploads may not work on some mobile devices.
Signed - EXHIBIT A ADDENDUM - MS *
No File Chosen
File uploads may not work on some mobile devices.
Signed - EXHIBIT A ADDENDUM - RF/mm*
No File Chosen
File uploads may not work on some mobile devices.
Signed - EXHIBIT A ADDENDUM - RF/mm *
No File Chosen
File uploads may not work on some mobile devices.
Completed ALCIS Sample Submission Form*
No File Chosen
File uploads may not work on some mobile devices.

User Information

User Information is required to complete compliance screening. This is a mandatory requirement to access research facilities. 


Education level is requested to ensure that any information and/or training is provided at the appropriate level.

Address*
Race (Optional)
Gender (Optional)
Ethnicity (Optional)
Disabled (Optional)

Emergency Contact Information

All users are asked to provide emergency contact information. The person you list will only be contacted in the event of a health or safety emergency in which you are personally involved. You may list a parent, family member, spouse, or other trusted individual as your emergency contact.

Name (Emergency Contact)*

Principal Investigator (PI) Information

Name (PI)*

Billing Information

Invoices for each facility are generated and distributed monthly. If you select and use more than one facility in a single month, you will receive invoices for each facility's usage charges.

Bill to: *
Address*
Are there additional email addresses you would like to have cc'd on invoices?*
please separate email addresses by using ;

Account/PO Information

If no, a standard ASRC reference will be assigned.

Project Description

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