Roy J. Carver
Biotechnology Center

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Name

NetID

Which instrument will you be using? Training Required or Staff Assisted Use

Fortessa (2117A Everitt Lab

Accuri C6 (348 Burril Hall)

Symphony A1 (264 RAL

Symphony A1 (231 ERML)

Symphony A1 (2117A Everitt Lab)-No HTS

Symphony A1 (2117A Everitt Lab)-Need HTS

Melody Sorter (231 ERML)

Other

Email Addresses (for Google Calendar access)

Phone

Department

PI name

PI Email

FOAPAL (account to be charged)

BSL Level

BSL 1

BSL 2

Have your cells been transfected

Yes

If you answered Yes to the previous question, list the agent

Describe your project; type of analysis you will be performing

Date

BIOSAFETY LEVEL 2 RULES

Type your full name to sign this form and agree to Biosafety Rules of FCF

Director: Mayandi Sivaguru, Ph.D
231 Edward R. Madigan Laboratory,
1201 W. Gregory Drive,
Urbana, IL 61801

Phone: (217) 333-1214
FAX: (217) 265-5066
Email: sivaguru@illinois.edu

264 Burrill Hall MC-120
407 S. Goodwin Ave.
Urbana, IL 61801
217.333.7413