ADELAIDE MICROSCOPYAnalysis Enquiry and Registration Form

ADELAIDE MICROSCOPY

Analysis Enquiry and Registration Form

Please complete this form if you wish to use the microscopy services available at The University of Adelaide

*Denotes a mandatory field

User Type*

Select whether you are internal or external to The University of Adelaide.

If you are external, please advise if you are from another research or industry organisation.

Note that this category and the information provided within this form will determine the instrument charge rate available to you. Please refer to our website for further information.

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I am University of Adelaide*

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I am an external

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First Name*

Family Name*

Title*

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Other

University of Adelaide ID number*

Please include the 'a' followed by your seven digit number

ORCID iD*

If you have an ORCID unique identifier, please enter it here.

If you do not have an ORCID, you can obtain one by visiting https://orcid.org/.

Research Discipline*

These are the categories used to report instrument hours metrics to the Federal Government

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Position / Title*

e.g. Research Assistant, Academic, PhD Candidate, Honours Student etc

Institution / Organisation Name*

Campus*

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Academic Faculty*

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School / Centre / Institute (Health)*

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School / Centre / Institute (Sciences)*

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School / Centre / Institute (Arts, Business, Law)

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Administrative Division Name

School / Centre / College

Institution / Organisation Street Address

Are you an Affiliated Titleholder with The University of Adelaide?*

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Please provide the current end date of your Affiliated Titleholder status*

Company Name*

Company Australian Business Number (ABN)*

Campus Street Address

Company Street Address

Phone Number

Email*

Are you a visiting international staff or student?*

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Home Institution*

End date at the University of Adelaide*

My supervisor is aware that I will be utilising facilities at Adelaide Microscopy and has agreed to cover associated costs*

If yes, your supervisor will be contacted and asked to provide project details, which will allow instrument bookings to be made in your name.

If no, please provide project and invoicing information as requested below.

NOTE THAT INSTRUMENT BOOKINGS MAY NOT BE MADE UNTIL YOUR PROJECT OR INVOICING INFORMATION IS PROVIDED.

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Supervisor Details

Primary Supervisor Name*

Primary Supervisor Email*

Secondary Supervisor Name (if applicable)

Secondary Supervisor Email (if applicable)

Research Funding Information

Funding Source*

Name of Funding Body (eg. NHMRC, ARC etc)

Grant ID Number*

Unique ID as assigned by the Funding Body

Project Title*

Brief description of your project

University of Adelaide Department ID*

Enter N/A if you do not have access to a UoA project code

University of Adelaide Project Code*

Enter N/A if you do not have access to a UoA project code

Is this Industry-related research?*

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Please indicate which Industry Sector this research relates to:*

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Name of person that invoices should be sent to (if not yourself)

If you leave this field blank, invoices will be sent to you directly via the email address you have provided above.

Email of person that invoices should be sent to*

Please select the Field of Research Code relevant to this project from the list below*

Refer to the Australian Bureau of Statistics (ABS) website for further information.

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Microscopy Analysis Information

Have you used Adelaide Microscopy's services previously?

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When did you previously use our services?

Have you already been in contact with an Adelaide Microscopy staff member to discuss this particular analysis?*

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Which staff member?*

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What is your sample?*

Type of analysis required*

Please select all that apply. If you are unsure, please select 'Unknown' and include as much detailed information about your analysis as you can in the field below.

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Brief description of analysis required*

Is it hazardous?*

Select

Does your sample require a Risk Assessment and Safe Operating Procedure?*

If unsure, please discuss this with your supervisor before bringing samples into the facility. For further information refer to https://www.adelaide.edu.au/hr/hsw/performing-a-risk-assessment

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Please upload a copy of both your Risk Assessment and Standard Operating Procedure here*

Drag and drop files here or

How did you hear about Adelaide Microscopy?*

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Where did you hear about us?

Would you like to receive eNews from Adelaide Microscopy?

If you indicate 'yes', you will receive emails from us containing information about upcoming workshops and events

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Any additional comments?

By submitting this form, I certify that I have read and am familiar with the Adelaide Microscopy Health, Safety & Wellbeing Induction Guide*

Please download the guide from the following website: https://www.adelaide.edu.au/microscopy/facilities-services/health-safety-wellbeing

then check the box below to confirm that you have read this document.

Please acknowledge us*

Acknowledging Microscopy Australia and Adelaide Microscopy in presentations, posters and papers is evidence that major investment in microscopy and microanalysis equipment and experts has delivered important outcomes. This helps us to make the case for future investments to support world-leading research in Australia. Help us, help you!

In posters and presentations please use the Microscopy Australia logo. In publications please use the following text acknowledgement:

“The authors acknowledge the instruments and expertise of Microscopy Australia at Adelaide Microscopy, The University of Adelaide, enabled by NCRIS, university, and state government support”.

Acknowledgement of individual staff members is optional. You may also wish to add Microscopy Australia's Research Organisation Registry ID in brackets as follows: (ROR ID: https://ror.org/042mm0k03). Logos can be downloaded from https://micro.org.au/academic/publishing-your-research/

By ticking this checkbox, you confirm that you have read this statement and will acknowledge Adelaide Microscopy as outlined above.

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