Frederick Seitz Materials Research Laboratory
Central Facilities

Facility Use Proposal Form for Academic Research (U of I Investigators)

Title of Research Proposal:
Funding Source: Please specify for any item with "Other":
Account Number:
 
Chart  -  Funding  -  Organization  - Program  -  Activity(if specified)
- - - -  

An account number is REQUIRED for all U of I users.
(This is the account that will be billed for all usage.)
Please remember to include an activity code (subproject number) if there is one!
If you do not include your account number, your proposal will not be processed!

Proposal is: New     Change of Scope   If Applicable, Current Facilities User Number:
Subject of Proposal
(Check all that apply)
 Materials Science Physics Chemistry
Polymers Medical Applications Biological & Life Sciences
Earth Sciences Environmental Sciences Optics
Engineering Instrument / Technique
      Development
Other
1. About Your Investigators
Select the
Principal Investigator:

 
Students and Post-Docs: This is your faculty advisor, please select from pull down if listed.

If you PI is not in the pull down list: Select New Principal Investigator and the next page (form) will be for entering your PI's information. 


User: (Information on the researcher who will be performing the experiments.)
Title:
First Name:
Last Name:
Citizenship:
Employer/
Department:

 
Status:
Work Address:
Work Phone:
Email:
Net ID: Do not include @illinois.edu, @uiuc.edu, @uic.edu or @uis.edu.
FAX: (optional)
Alternate Phone: (cell / lab)
(optional)
FSMRL contacts or collaborators:
Check all that apply, at least one.

If unknown, check Mauro Sardela (Director of Facilities)
Mauro Sardela Steve Burdin CQ Chen Jeff Grau
Doug Jeffers Rick Haasch Jim Mabon Scott MacLaren
Lou Ann Miller Tao Shang Julio Soares Timothy Spila
Wacek Swiech Kathy Walsh Xiaoli Wang Lon Westfall
Honghui Zhou