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 HZB data protection information for forms and HZB data protection.