Department of Biomedical Sciences
Registration Form for BMS Smart Lock System
Please complete in BLOCK CAPITALS
APPLICANT INFORMATION
 New Application  Change Supervisor
Name:
1
La st Na me (i n BLOCK l etter )
Status:
 Faculty
User Type:
 Research Student (MPhil / PhD)
 Others:
 BMS User
 Non-BMS User
 Non-BMS User
(fo r n on -BMS a p p li ca n t o nl y )
(Co l l ab or a tor )
 ACE
 AP
 SKLMP
 BCH
CityU ID Card No.:
Valid Period:
(co n tr a ct o r stu d en tsh ip du r a ti on ):
(
DD
/
MM
/
(CSE E qu ip men t & Fa ci li ti es Sh ar in g Sy stem)
 MBE
 SEEM
 SEE
 Non-CityU User
Others:
CityU EID:
YYYY
(SH OULD BE P ROVI DED)
to
DD
CityU E-mail Address:
Safety Training Date:
)
________________________
 EE
)
 Add Room
 Change Card
 Research Staff (SRF / RF / PDF / SRA / RA / TA /
Department:
2
 Extend Contract
Fi r st Na me (i n BLOC K l etter )
/
MM
/
YYYY
Contact No.:
BMS Safety Induction finished on:
DD
/
MM
/
YYYY
Web-based Laboratory Safety
Training finished on:
DD
/
MM
/
YYYY
DD
/
MM
/
YYYY
Risk Assessment Form Submission Date :
ROOM
Room no.
Endorsed by room-in-charge
Checked by
(p l ea se see n ext p a ge fo r d etai l s)
(fo r BM S o ffi ce u se o nl y )
Please attach additional form if space prov ided is not enough.
Notes:
You are required to re-submit this form if you change supervisor.
1
2
Accessible time slot: 0700 to 2300
Format of CityU ID card no.: I D card no. + card issued no . in bracket s, e.g., 00123456(3 )
Staff Card
Student Card
CityU ID card no.
Card issued no.
(Please fill in “0” in the brackets if
there is no number)
Signature of Applicant:
Supervisor Approval:
Date:
Prof. / Dr.
DD
/
(for collaborator of non-BMS or non-CityU user only)
)
(
)
Na me (i n BLO CK l etter )
FOR OFFICE USE ONLY
Si gn a tur e
(Form Received On:
DD
/
MM
/
YYYY
Date:
DD
/
MM
/
YYYY
Date:
DD
/
MM
/
YYYY
Endorsed by Smart Lock System Administrator:
(
Na me
YYYY
Si gn a tur e
Prof. / Dr.
Data Input by:
/
(
Na me (i n BLO CK l etter )
BMS Host Approval:
MM
)
)
Si gn a tur e
Last Updated: 11 Sept 2015
BMS smart lock room information with staff/tech -in-charge
Room No.
Room Name
Endorsed by Staff/Tech -In-Charge
Equipment/Functional Room
BMS main entrance, entrance at Lift 9, entrance near Y2304 and rear entrance are automatically added for all BMS staff/students.
1
B2301
Teaching lab (Main)
2
B2302 & B2303
Teaching lab (Medical Microbiology Lab)
3
B2314
Teaching lab (Clinical Chemistry &
Molecular Diagnostic Lab)
4
B2321
Teaching lab (Gel Electrophoresis Lab)
5
B2320 & B2324
Tissue culture room 1
6
Y2312 & Y2314
Tissue culture room 2
7
Y2316 & Y2320
Tissue culture room 3
8
Y2305
Washing room
9
Y2306
Autoclave room
10
Y2321
Cold room
11
G2438
Technical staff office
12
G2519
Receiving counter
13
G2504
14
B2313
Temp. imaging lab
15
B2315
Temp. equipment room
16
B2319
Biosafety Level 2 lab
Research Laboratory
17
G2431
Research Laboratory
Dr. LF Huang & Dr. JB Yue
18
19
G2435
B2307
Research Laboratory
Research Laboratory
Dr. ML He, Dr. KC Chan & Dr. ZL Zheng
Dr. X Yao & Dr. Gigi Lo
20
21
B2311 & B2312
B2316
Research Laboratory
Research Laboratory
Prof. Ying Li
Dr. JH Shi & Dr. M Le
22
23
B2328
B2329
Research Laboratory
Research Laboratory
Dr. X Yao
Dr. Gigi Lo
24
25
B2318
Y2304
Research Laboratory
Research Laboratory
Dr. YJ Lee & Dr. WJ Xiong
Dr. SC Yang
26
27
Y2311
Y2322
Research Laboratory
Research Laboratory
Dr. X Wang
28
29
30
31
32
Last Updated: 11 Sept 2015