OMNI Confocal Microscopy Project Registration

Every user MUST have completed this form and have their project approved BEFORE use of equipment can commence. Failure to do so may make you liable for any damages caused during unauthorised use.

USER DETAILS

Please complete all marked sections and other relevant options.
Name Name First Last
Department
Email
Phone Number
Position

Position Staff Principal Investigator Post-doc PhD Masters Postgraduate Other Undergraduate Other
Staff or Student ID Number
Principal Investigator's Name (if you are part of a research team) Principal Investigator's Name (if you are part of a research team) First Last
Supervisor's Name (if you are a student) Supervisor's Name (if you are a student) First Last
Supervisor's or Principal Investigator's Email (If applicable)
Grant Name/Number

This allows us to collate funding sources and aids planning for future equipment and research directions.
Standard and Tier usage charges below:
Please note, tiers expire at the end of the calendar year and we cannot roll unused hours into the following year
Start Date Start Date / DD / MM YYYY
Estimated End Date Estimated End Date / DD / MM YYYY
TECHNIQUE
Technique(s) Required

Technique(s) Required Light microscopy Confocal Microscopy Nikon Ti2E Inverted Widefield microscope Nikon C2+ confocal microscope Nikon A1+ confocal microscope Opera Phenix HCS spinning Disk confocal microscope Andor Dragonfly Spinning Disk confocal microscope Bruker BioScope Atomic Force Microscope SkyScan X-Ray Micro-CT

The Nikon A1R is NOT a general use confocal microscope. Only tick this option if you are part of an approved laboratory group, or have contacted Andrew McNaughton in the first instance.
Brief Description of Project.

This information is used when making bids for equipment funding and is very important. Please take the time to describe your project clearly and concisely.
ACCOUNT CODE
Account Code

Your account code will begin with GL if it is a General Ledger account and PL if it is a Project Ledger account.
HEALTH AND SAFETY
Requires PC2 Containment?

Requires PC2 Containment? Yes No
Upload PC2 Training Form

Attach Files
Are you using human tissue?

Are you using human tissue? Yes No
Do you have any allergies? eg. latex gloves.

Do you have any allergies? eg. latex gloves. Yes No
List allergies, if relevant.
Additional Information

If you have specific requirements relevant to your project please describe them here.
TERMS AND CONDITIONS OF USE
https://www.otago.ac.nz/omni/confocal-microscopy/otago691756.html#registration
Read Terms and Conditions / User Policy

Read Terms and Conditions / User Policy Yes

By ticking this box you acknowledge having read, and agreed with, the Terms and Conditions.

OMNI Confocal Microscopy Project Registration

OMNI Confocal Microscopy Project Registration

USER DETAILS

Standard and Tier usage charges below: Please note, tiers expire at the end of the calendar year and we cannot roll unused hours into the following year

TECHNIQUE

ACCOUNT CODE

HEALTH AND SAFETY

TERMS AND CONDITIONS OF USE

https://www.otago.ac.nz/omni/confocal-microscopy/otago691756.html#registration

Standard and Tier usage charges below:
Please note, tiers expire at the end of the calendar year and we cannot roll unused hours into the following year