FLIPR Registration Form

MUSC FLIPR^tetra RESOURCE FACILITY

REGISTRATION FORM

Researcher/Principal Investigator:

First Name:*

Last Name:*

Phone:*

Email:*

P.I. First Name:*

P.I. Last Name*

Department

Department Name:

Financial Contact:*

Financial Contact Phone:*

Funding

Funding Source (NIH, Corporation, etc.)*

UDAK#:*

Hourly Usage Rate:
$50/hr. (Federal, Non-profit, etc)
$100/hr. (Private, Corporate)

Details

Assay desired (if known):

Cell type to be used (include species: i.e. human, rat, etc.):

Will cells be transfected?*

Yes

If yes, describe construct:

Describe any special biosafety conditions/requirements needed for assay (biohazards / radioactivity / organics, etc.):

CONTACT: Dr. Tom Morinelli
Email: morinelt@musc.edu

FACILITY LOCATION: Strom Thurmond BLDG. Rm 519 Phone: 792-0071

Fields marked with * are required.

Number

Information For