SCRIPT Project Request Form

This form is for requesting access to clinical, sequencing, and other omics data and/or samples from the Successful Clinical Response In Pneumonia Treatment (SCRIPT) Systems Biology Center. Please provide as much detail as possible in your request. Proposals will be reviewed by the SCRIPT leadership team on a monthly basis.

Project Requester Information

First Name

Last Name

Email Address

Affiliation(s)

Northwestern University

Other Academic Institution

Non-Academic Collaborator

Northwestern netID

If you do not have an NU netID, please enter NA.

Role

Collaborators

Other collaborators

If relevant, please provide the names of the other individuals at your institution or individuals from the SCRIPT team who will be collaborating on this project.

Project Information

Project Title

Type of Request:

Data

Samples

Project Description

In a brief description (1-3 short paragraphs), explain your proposed project and how it will utilize the data or samples you selected above. If you intend to use additional non-SCRIPT data or samples as part of this project, please provide a brief description of that data as well.

If relevant, please enter your project deadline here:

mm/dd/yyyy

Additional Information

If there is anything else you would like to share with the SCRIPT leadership team regarding this project (e.g., conference abstract submission), please do so here.

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