BOSCH INSTITUTE
LIVE CELL ANALYSIS FACILITY /
REGISTERED USERS ARE DEFINED AS THOSE PEOPLE WHO HAVE COMPLETED THIS REGISTRATION FORM AND AGREED TO PAY THE FULL ACCESS FEE. A REGISTRATION FORM AND ACCESS FEE MUST BE COMPLETED FOR EACH USER OF THE OSBF INDEPENDENTLY FOR EACH CALENDAR YEAR. THOSE PEOPLE INCLUDED IN THE SoMS DIRECTORY WILL BE ELIGIBLE FOR THE SoMS MEMBER RATE OF $418 PER ANNUM. THERE IS NO CAP PAYMENT FOR MULTIPLE LAB MEMBERS. OTHER MEMBERS OF THE UNIVERSITY OF SYDNEY (NON-SoMSMEMBERS) WILL PAY AN ACCESS FEE OF $595. ALL OTHERS MUST PAY THE EXTERNAL USER FEE OF $1500.
NOTE: ALL REGISTERED USERS MUST UNDERTAKE APPROPRIATE TRAINING BEFORE USING THE FACILITY – DETAILS CAN BE OBTAINED FROM THE CORE FACILITY OFFICER. IN THE EVENT THAT SOMEONE IS FOUND TO HAVE MISUSED THE FACILITY, ACCESS MAY BE WITHDRAWN.
FOR FULL DETAILS ON ACCESS FEES AND THE USAGE OF BOSCH CORE FACILITIES PLEASE READ “GUIDELINES FOR THE USAGE OF BOSCH CORE FACILITIES”.
Registration Details (Please Print)
Title: _____ Surname: ______Given Name: ______
Staff/Student ID:______Position: ______
Bosch Research Laboratory: ______
[Note only those listed on the Bosch Directory will be counted as Bosch Members for the purpose of determining Access Fees]
Or External Address: ______
Contact No: ______Email: ______
Duration of access: ______to 31 December 2016
Name of Supervisor: ______
Have you Completed the Training Requirements? Yes No (Please tick))
Date Training Completed:______Details:______
Facility Membership Fee for 2015:
SoMS Member: $ 418.00
University of Sydney Member:$ 595.00
External:$ 1500.00
Access Fee Payment - Journal Transfer (Please print details)
I ______from the Discipline of ______
PLEASE NOTE: Reagents and consumables used in the LCAF will be charged to the account below
Endorse the journal transfer of from my account code:
Amount:$418$595$1500 (Please tick one)
Class:5414 RC: ______Project: ______Analysis: ______
Being 2015 Access Fee for the Live Cell Analysis Facility:
Registered User: ______
Signed (Supervisor, HOD etc): ______Date:______
To be completed by the Bosch LCAF Officer:Date Sent to Accounts: / ______/ Date Completed: / ______
ProjectDescription (Please Print)
Project Title:______
Project Description ______
Do your samples contain any biological hazards?: ______
______
Which equipment do you wish to use:
FACS Calibur Cryostat F13 Cryostat K25 BX51 Microscope Centrifuges Spectrophotometer
EVOS Cell Culture equipment Other (please specify)
Any other relevant information: ______
______
______
______
______
______
Conditions of Use
- The Registered User will have access to the Bosch Live Cell Analysis Facility and the Medical Foundation Building.
- The Registered User must undertake appropriate training with the Live Cell Analysis Facility Officer prior to using specialised equipment and/or areas.
- The Registered User must at all times follow all rules and procedures for the use of the facility including the wearing of any required safety clothing, if appropriate.
- The Registered User will be responsible for the general maintenance and cleanliness of the equipment and areas being used including the safe disposal of any waste materials.
- The Registered User must report any accidents or misuse of the Facility to Dr Angeles Sánchez-Pérez 9036 3223 or 0421 846 284.
- The Registered User must NOT allow access to non-registered users.
- Prior to the commencement of access, the Registered Users must have completed and have a delegated authorised signature on the Access Fee Payment – Journal Transfer Form.
- In the event that you breach any of the obligations under this Agreement, the Bosch Institute is entitled to terminate this agreement without notice.
- This Bosch Core Facility should be acknowledged on all publications and presentationsresulting from its use, and, if appropriate, the Core Officer should also be acknowledged.
Agreement
Agreement
I agree to the above terms and conditions.
Name ______
Signed ______Date ______
Please book instruments on:
Thank You