Application to use the Mass Spec, CHN or NMR facility (Charges Apply)
Your Name and Address (followed by Project and Award Codes). External customers will be invoiced.
Username
This will be provided and match any NMR
username you may have
Password
Required
Title
Required
This may be adjusted if necessary
Salutation (Ms, Mr, Dr etc)
First Name
required
Last Name
required
Status
Lecturer
Senior Lecturer
Reader
Professor
Academic Fellow
Research Fellow
Senior Research Fellow
Independent Research Fellow
Maplethorpe Fellow
Visiting Research Scientist
MPharm Student
MSc Drug Discovery Student
MSc Drug Delivery Student
PhD Student
Researcher
Research Assistant
RCUK Academic Fellow
Technician
Research Technician
Senior Technician
Specialist Services Technician
Laboratory Manager
Experimental Officer
(copy + paste from
list on right or circle
in pdf file)
Add another status
if not present in list
Address Code
SOP
See below if an external customer
Building Name
Pharmaceutical and Biological Chemistry
Pharmaceutics
Pharmacology
CR-UK Biomolecular Structure Group
CR-UK PPIs Drug Discovery Research Group
Gene Targeted Design Research Group
Molecular Neuroscience Research Group
Centre for Cancer Medicines
Centre for Drug Delivery Research
Centre for Pharmacognosy and Phytotherapy
Department
(copy + paste from
list on right or circle
in pdf file)
Add another Dept
or Centre if not
present in list
Lab Number
Internal
Email
Static Phone
yes
(Work at the UCL SoP)
yes or no
Will appear on submission form and mass
email lists
Lab or Office phone number
Supervisor 1
Provide at your discretion
(Use Lab or Office number in preference)
Does not appear on submission form
First and Second names
Supervisor 2
First and Second names
Mobile Phone
Will only be used in extreme cases
Notes
Address if different to the UCL School of Pharmacy (address code SOP)
Institution
University
Street
County
City
Country
Post Code / Zip Code
Enquiry Phone
General institution number
Enquiry Fax
General institution number
Cont …
MASS SPECTROMETRY Project codes:
Please provide project and award codes that you will use for MS/CHN
(Please specify just one of the main project holders)
No
PROJECT CODE
AWARD CODE
Project Holder
First Name
Project Holder
Second Name
PROJECT
Start Date
Eg 01/10/2014
PROJECT
End Date
Eg 30/09/2017
1
2
3
4
Must be signed off as correct by Project Holder/ Supervisor below:
(print page and acquire signature)
1
2
3
4
NMR (a short introductory training will be provided)
Project codes: Please provide project and award codes that you will use for NMR submissions
No
PROJECT CODE
AWARD CODE
Project Holder
First Name
Project Holder
Second Name
1
2
3
Must be signed off as correct by Project Holder/ Supervisor below:
1
2
3
Please return this form to Colin James (colin.james@ucl.ac.uk) in office 410
OR
Emmanuel Samuel in office (e.samuel@ucl.ac.uk) in office B58
PROJECT
Start Date
Eg 01/10/2014
PROJECT
End Date
Eg 30/09/2017