Biomedical Imaging Center Biology Preparation Rooms Application Form

Name (Affiliation)
E-mail address
Room you want to use	Biochemistry Preparation Rooms  Physiology Preparation Rooms
Proposal No.
Period of use
Instruments to be needed
Reason why you need to use the room(s)

*It is mandatory to fill in all boxes. Sending this form does not automatically grant the use of the rooms. The applicants must consult the administrator about the details of the use. Depending on circumstances, the applicants may be asked to use other falicities including the Biology Preparation Room at Ring.