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USER FORM
All fields are required except indicated separately. Missing information may delay the processing of your application.
Submit Type
Submit Type :
User Information
User From :
MCB 481 Course :
First Name :
Last Name :
UC ID :
User Status :
E-mail :
Work Phone :
Other Phone :
Department :
Insititution / Company :
Work Address :
Supervisor Information
PI First Name :
PI Last Name :
PI Phone :
PI Email :
Billing Information
Please provide the billing account number of a Acct-Fund-Org-Pgm-Sub type (eg: 12345-67890-44--ABCDE ) or a 10 letter Speedtype (eg: CE01234567). For LBNL users, please provide the Purchase Order(PO) Number.
Federal Tax ID :
Billing Account / PO :
Billing Address :
Billing Contact Person :
Billing Phone :
Billing Email :
Reason for Use EML
This description should indicate the nature, scope, and expected results of your research project.
EM facility to use :
Reason for Use :

I certify that I have taken all required EH&S compliance training for researchers and task specific training for the types of samples I will be using ( EH&S UC Berkeley, EH&S LBL). If asked, I will supply all hazard and safe handling data for samples I bring into the laboratory.
I certify that I have reviewed the EML Standard Operating Procedure for the type of instrument that I will use.
I agree to comply with the EML Terms of Use and agree that any costs incurred over the authorized amount will be paid for myself.
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