General Lab Information

User Facility Agreement Questionnaire

*All fields are required except those listed as optional.

Institution Information

Is your company considered a small business? No Yes

When will personnel from the above-named institution begin working at Brookhaven?(Leave blank if unknown.)

Which user facilities will be hosting you? Accelerator Test Facility (ATF)
Center for Functional Nanomaterials (CFN)
NASA Space Radiation Laboratory (NSRL)
National Synchrotron Light Source II (NSLS II)
Relativistic Heavy Ion Collider (RHIC)


User Agreement Details

What type(s) of experiments will be done at Brookhaven by individuals of the above-named institution?

Non-Proprietary
Proprietary
Non-Proprietary and Proprietary

To Whom Should the User Agreement(s) Be Sent for Authorized Legal Signature?

Such as Legal Department, Sponsored Research Office, etc.


Contact Information for Person Completing This Questionnaire

Use the Person Listed Above Someone Else


Verification    (Not readable? Generate new image.) captcha image

Type the characters on the left into the text box on the right.

Reset Form Submit Form