Equipment & Lab Use Request Form

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Please fill out the form below to indicate the item(s) you are requesting and the day(s) and time(s) needed. A fee is associated with Lab space and equipment use. Training and a project planning session is required for approval and planning purposes.

Personal Information

First Name:

Last Name:

Are you a UMass Boston student:

NoYes

If you are not a UMass Boston student, at which institution are you currently matriculated?

Major:

Phone:

Email:

Student ID Number:

Affiliation Name:

Affiliation Phone:

Affiliation Email:

If other, please explain:

Is your project funded:

NoYes

What is your funding source?

What date are you requesting to borrow?

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