Project Application

Fill in the form below and click on the "Submit" button at the bottom of the page. Once submitted, you will receive an email with a unique code which will be used to login to the scheduling site. The code will be your login for the scheduling site. Each time you begin a new project or course, a new code must be used to login.

At the end of your project or course, you will no longer be able to login using the code generated from your initial application. To schedule future dates, a new project application must be completed.

Not all requested items are applicable to all users. Please leave non-applicable fields blank.

I. Contact Information

Type of Project: Research Industry Education Other   If Other, Please Explain


Project Title:


Course Code (Students Only):

Principal Investigator/Advisor:


Department/Institution/Company:


PI/Student Address:
PI/Student Campus Mail Stop (if applicable):
PI/Student Telephone Number:   PI Fax Number:
PI/Student E-mail Address:

Co-PI (if more than one PI)/Student Name:


Co-PI/Student Department:


Other Project Personnel
Name:  Department:
Name:  Department:
Name:  Department:
Name:  Department:
Name:  Department:
Name:  Department:
Name:  Department:
Name:  Department:
Name:  Department:
Name:  Department:

Type of Research

Type of Research: Material (non Biological)    Biological
Choose one: Animal    Human    Plant    Microbial    Insect
Is your sample a possible pathogen? Yes    No
Is your sample infectious? Yes    No
Please fill in IBC Number in Section II below. IBC Number is a required field.

If you are using radioactive materials in research activities, you must become an authorized radioactive materials user. A screening form must be filled out for each participant. Each participant MUST submit this form before entering the MRI area. List species/sample type:
For MRI 
Is the animal deceased?  Yes  No

II. Compliance Information (for MRI / West location only)

All human research conducted at, by, or under the auspices of this institution, whether funded or not, and whether conducted by the administrators, faculty, staff, or students, must be reviewed and approved before the research begins.
IRB Approval Number:     Expiration Date:

University instructors and researchers planning projects that utilize animals must submit their proposed protocol to the Institutional Animal Care and Use Committee for review and approval of animal care and use aspects.
IACUC Approval Number:     Expiration Date:

The IBC application is a risk assessment done by the Principal Investigator (PI) on his/her proposed research involving biohazardous materials which is then independently reviewed by the IBC.
IBC Number:   Expiration Date:

If you are using radioactive materials in research activities, you must become an authorized radioactive materials user.
Radioactive User Approval Number:   Expiration Date:

Please list IRB/IACUC Training Completion Dates for Each Person Involved in Research:
Name:   Training Completed on Date:
Name:   Training Completed on Date:
Name:   Training Completed on Date:
Name:   Training Completed on Date:
Name:   Training Completed on Date:
Name:   Training Completed on Date:
Name:   Training Completed on Date:
Name:   Training Completed on Date:
Name:   Training Completed on Date:
Name:   Training Completed on Date:

IV. Equipment Usage Request

Please indicate below which capabilities you anticipate using for this project.

I²AT East (Basement of Clay Lyle Entomology Building, MSU Campus):
Confocal Laser Scanning Microscope
Atomic Force Microscopes
	Dimension Icon AFM with ScanAsyst
	BioScope Catalyst AFM with ScanAsyst
Scanning Electron Microscopes
	Field Emission SEM
	Variable Pressure SEM
Transmission Electron Microscope
X-Ray
X-Ray Diffractometers
	Rigaku Ultima III X-ray Diffraction System
	Rigaku SmartLab X-ray Diffraction System
For Outreach Only:
Table-Top SEM
Caliber AFM
I²AT West (Corner of Stark Rd. and Hwy 182 W):
3T MRI
CT Scanner
4D Ultrasound
Linear Accelerator
Fluoroscopy

Expected Duration of Study:   Start   Finish
Brief Description of Study:

Protocol/Parameters (for MRI only: for set up purposes the MRI Tech needs a description of what you are looking for)

Note for MRI scheduling:

IACUC standards require specific cleaning practices to take place prior to any animal research activities. We cannot guarantee admittance to the animal bay area before 5:30 p.m. Please keep this in mind when scheduling the MR for animal subjects that require preparation time (e.g. anesthesia). If you schedule an MR for 5:30 p.m. for an animal subject that requires use of the animal bay area and you would like to prepare the animal for MR prior to 5:30 p.m., you can call ahead (662-325-3019) to check whether the area is ready prior to 5:30 p.m.

V. Signature

By clicking the box below you agree that the information you have provided in the application is true and accurate, you also agree to our 24 hour cancellation policy and the confidentiality obligations (when appropriate).

By clicking this box, you have provided your electronic signature.