SCRIPT Project Request Form

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

Please provide your other affiliation here.*

Northwestern netID*

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

Role*

Select

What is your other role at your institution?*

Collaborators

Project Lead*

Please provide the name of the individual at your institution who will be overseeing this project.

Project Lead Email Address*

Please provide the email address of the individual at your institution who will be overseeing this project.

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

Data Request*

Bulk RNAseq

Clinical data

Cytokines

DNAseq

Flow Cytometry

Metagenomics

scRNAseq

Whole Genome Sequencing

Other

Sample Request*

Bacterial/Viral Isolates

Native BAL (unprocessed)

Plasma

Supernatant BAL

Whole Blood

Other

What other SCRIPT data or samples are you requesting?*

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.

Sample Analysis Plan*

Please provide a brief analysis plan, including details of the proposed assay, sample volume required, power calculations and number of samples requested.

What type of data are you requesting?*

Deidentified data

Limited data (includes clinical dates)

If relevant, please enter your project deadline here:

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.

Send me a copy of my responses

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