Mainpage >Research >Functional Materials >Soft Matter and Functional Materials >Research >Macromolecular Crystallography >The HZB-MX BioLab >Registration form

Registration form

This form needs to be submitted for evaluation at least seven days prior to the proposed starting date. For questions, please contact Dr. Manfred Weiss.

Last Name*

First Name*

Title

Affiliation*

Email address*

Telephone number*

HZB-employee*

Yes No

if yes, unit

Group Leader

User*

Yes No

if yes, affiliation

Contact at HZB

Other, please specify

Start Date*

Anticipated duration of the proposed experiment*

Detailed description of the proposed experiment(s) to be performed in the BioLab*

Reason for the need of access to the BioLab*

Complete list of equipment to be used for the proposed experiment in the BioLab*

Complete list of equipment to be brought into the BioLab*

Complete list of Chemicals to be used for the proposed experiment in the Biolab*

Complete list of Chemicals and substances to be brought into the BioLab (Please note: for each chemical or substance brought into the BioLab, a Material Safety Data Sheet has to be provided).*

Maximum Biological Safety Level of substances brought into the BioLab (BioStoffV)*

Are you planning to bring GMOs into the BioLab?*

Yes No

If yes, please detail, organism, strain, mutant, safety level

Is there any hazardous potential associated with the chemicals and substances you bring into the BioLab?*

Yes No

If yes, please detail

Do you require storage space in the BioLab?*

Yes No

If yes, where? (for multiple answers hold "strg" with your choice)

Complete list of chemicals and substances to be stored in the BioLab (Please note: the maximum storage time cannot exceed the duration of this access proposal).*

Will you produce waste in the BioLab as a result of the proposed experiment?*

Yes No

If yes, please detail

If yes, how is the disposal organized

Declaration*

I hereby declare that I have filled out the access request form to the best of my knowledge, that I have read and understood the Directive for Operations (Betriebsanweisung) for the BioLab and that I am responsible for the correct labelling and storage of all chemicals and substances, which I will bring into the BioLab and store there, and for the removal of all waste material, which is produced as a result of my experiments in the BioLab.

By ticking this box on the online form, I agree to personal data processing and utilization according to the conditions (data - protection information) mentioned above.