Materials Research Laboratory - Grainger College of Engineering
Central Research 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 your 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:
Employer/
Department:
 
Status:
Work Address:
Work Phone:
Email:
Net ID: Do not include @illinois.edu, @uiuc.edu, @uic.edu or @uis.edu.
Alternate Phone: (cell / lab)
(optional)
MRL contacts or collaborators:
Check all that apply, at least one.

If unknown, check Mauro Sardela (Director of Facilities)		 Mauro Sardela Mohammad Ali Rajen Basu CQ Chen
David Ehrhardt Kristen Flatt Rafael Silva Goncalves Rick Haasch
Mrinal Hota Ying He Toyanath Joshi Peter Kurath
Miao Liu Juan Lopez Greg MacDougall Lou Ann Miller
Roddel Remy Allison Sibert Julio Soares Timothy Spila
Pengcheng Sun Kathy Walsh Xiaoli Wang Zhiyu 'Jade' Wang
Lon Westfall Honghui Zhou