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What is your background ?
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Postal Code
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Are you consulting for a new project or an ongoing one ?
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New Project
Ongoing Project
Please provide the title of the ongoing study
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How can we help you?
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Supervisor/PI Information
Is Your Supervisor/PI a Member of 捆绑SM社区?
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Yes
No
Not applicable
Supervisor/PI First Name
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Supervisor/PI Last Name
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PI 捆绑SM社区 Email Address
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Institutional Email Address
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Department
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Building
Room Number
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Phone Number
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Institution
*
Address
*
City
*
Province/State
*
Country
*
Canada
Afghanistan
Aland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
British Virgin Islands
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Caribbean Netherlands
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo (Brazzaville)
Congo (Kinshasa)
Cook Islands
Costa Rica
Croatia
Cuba
颁耻谤补莽补辞
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Honduras
Hong Kong S.A.R., China
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Ivory Coast
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao S.A.R., China
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
North Korea
Norway
Oman
Pakistan
Palau
Palestinian Territory
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
Saint Barth茅lemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
U.S. Virgin Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Vatican
Venezuela
Vietnam
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Postal Code
*
I understand that my supervisor might be sent an invoice payable by cheque to 捆绑SM社区 within 30 days of the issued date in accordance with the rules of use of the Facility.
*
Yes
I agree that I might be sent an invoice payable within 30 days of the issued date in accordance with the rules of use of the Facility.
*
Yes
Project Form
Do you have prior experience in imaging ?
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None
Basic
Intermediate
Advanced
Please provide details of your experience
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Are your samples derived from animal or Human subjects ?
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Yes
No
Did you obtain the approval from the Ethics committee ?
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Yes
No
Please provide your permit number
*
What is the biohazard level of your sample ?
*
If you have multiple samples, indicate the highest biohasard level.
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Biohazard level 1
Biohazard level 2
Biohazard level 3
Do you have a valid Biosafety certification ?
*
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Yes
No
Type of Samples
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Fixed Cells
Live Imaging
Tissue section
Whole Organism
Non Biological Material
Other
Please specify
*
Brief Title of your project
*
Provide as much detail as possible on your project so we can better determine your needs. What is the scientific question you would like to answer? What is the structure you intend to image? Where in your sample do you expect to localize areas of interest/fluorescent signal?
*
Which imaging/illumination technique(s) are you planning to use?
*
I am not sure, I need advice
X-rays
Brightfield
DIC
Phase contrast
Darkfield
Fluorescence
Electrons
Which instrument(s) are you planning on using?
*
I am not sure, I need advice
CT-scanner
Epifluorescence Stereomicroscope
Upright Widefield epifluorescence microscope
Inverted Widefield epifluorescence microscope
Structure Illumination (Apotome)
Laser scanning confocal microscope
Spinning disk confocal microscope
Total Internal Reflection Fluorescence
Scanning Electron microscope
Critical Point Dryer
Sputter Coater
Microwave for sample preparation
Ultramicrotome
Cryotome
Freeze-fixation and substitution
Image Analysis
Imaris
Fiji-ImageJ
Which dyes/labels you are planning to use?
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What are your positive controls ?
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What are your negative controls ?
*
Does your CT-experiment require special needs?
*
To select multiple choices hold the Ctrl key and select all the applicable choices.
None
I am not sure, I need advice
Access to the green-house
Access to a growth chamber
Access to a cold chamber
Other
Does your experiment require special needs?
*
To select multiple choices hold the Ctrl key and select all the applicable choices.
None
I am not sure, I need advice
Z-stack
Time-lapse
Multichannel
FRAP
Tilling
CO2/O2 control
Temperature control
Imaging through plastic
Well plates (6 to 96)
Over-night imaging
Other
Please specify
*
Please specify
*
What kind of coating do you need?
*
I am not sure, I need advice
Au/Pd coating
Carbon Sputtering
What event are you expecting to record/see? How long does the event last? For how long will you need to image? What is the frame rate?
*
Most microscope objectives in the Facility are corrected to work with #1.5 coverslips, (0.17mm thickness) please check that this is what you are using before starting any experiments.
*
Yes
Targeted Start Date
*
Month
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
Day
1
2
3
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11
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14
15
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21
22
23
24
25
26
27
28
29
30
31
Year
Year
2022
2023
2024
2025
2026
I agree to NOT bringing any BSL2 or BSL3 samples into the Facility without written authorization from the Facility Manager.
*
I agree
Please download and read the following document detailing the
Usage policy of the Multi-Scale Imaging Facility
.
Please download and read the following document detailing the
Usage policy of the Multi-Scale Imaging Facility
.
听
I certify that the information I am submitting is accurate. I have read, understood and accepted the rules of use of the Multi-Scale Imaging Facility as set out in the above attached document and will follow them to the very best of my ability. I understand that an infringement to these rules can result in a restricted use and/or a temporary or permanent ban from the Facility. I acknowledge that an infringement of the Ethical Policy may result in an official report to my Supervisor and/or the Chair of my Department and/or the Dean of my Faculty and may lead to disciplinary or legal action.
*
I agree
I certify that the information I am submitting is accurate. I have read, understood and accepted the rules of use of the Multi-Scale Imaging Facility as set out in the above attached document and will follow them to the very best of my ability. I understand that an infringement to these rules can result in a restricted use and/or a temporary or permanent ban from the Facility. I acknowledge that an infringement to the Ethical Policy may result in an official report to my supervisor and/or the Chair of my Department and/or the Dean of my Faculty and may lead to disciplinary or legal action. I authorise the Multi-Scale Imaging Facility to send me an invoice payable by cheque to 捆绑SM社区 within 30 days of the issued date in accordance with the rules of use of the Facility.
*
I agree
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