Destructive Sampling Request Form

Destructive Sampling Request Form
Borrower’s details
Name of borrower:
Institutional address:
Postal address for loan (if different):
Herbarium code:
Email address:
Telephone number:
User’s details (if different from above)
Name of user:
Institutional address:
Outline experience & qualifications:
Herbarium code:
Email address:
Telephone number:
Supervisor’s details (If user is a student or postdoctoral fellow)
Name of supervisor:
Institutional address:
Outline experience & qualifications:
Herbarium code:
Email address:
UNB use only
Telephone number:
Date received:
Processed by:
Proposed project
Response sent:
Outline including explanation of destructive sampling methodology
Please provide examples of previous studies (publications) proving your competence and
success with the proposed destructive sampling techniques
Specimens requested for destructive sampling
Expected outcomes (Y?N)
Publications Images Organismal Genbank
I understand that my application only constitutes a proposal and that samples can only be
used as approved by UNB staff and in a manner consistent with UNB’s Destructive
Sampling Guidelines
I understand that type specimens, specimens from extinct or endangered taxa and
specimens that are poorly represented in the collection will only be loaned in exceptional
I will return the specimens, properly labeled subsamples of any specimens (example
slides) and copies of any resulting publications in a timely matter.
I understand that the specimens are not to be forwarded to any other researchers without
the express approval of UNB staff and submit that the analyses are intended strictly for
academic research based on the proposal outlined above and not for any other purposes,
academic or commercial.
Borrower’s signature:
Borrower’s Name/Title: