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I4S Recipient Application
Please fill out this form to become a recipient of an I4S donated machine. We hope to accommodate all requests but it may take some time. If you have any questions, please contact education@isac-net.org.
1.
Name
2.
Email
3.
Phone Number
Institutional information:
4.
Name of Institution
5.
Address/ Location of the instrument
6.
Contact Information
7.
When do you wish to receive a flow cytometer?
8.
Describe the flow cytometer capabilities needed?
9.
What type(s) of assays will be run on the cytometer?
10.
Is there local technical support?
Yes
No
Unsure
11.
Please list manufacturers that could provide local support.
Please indicate your financial ability to contribute for each of the following categories:
12.
Installation
13.
Annual maintenance of the cytometer?
14.
Shipping costs?
15.
ISAC Memberships for your lab members?
16.
Are you an ISAC member/ know an ISAC member or a member of an ISAC Associated Societies?
17.
Please share any related publications from your lab.
18.
Do you have any collaborations in the US or EU?
Yes, in the US
Yes, in the EU
Yes, in both the US and EU
No
Unsure
19.
Are you willing to share progress with I4S on a regular basis, post installation?
Yes
No
20.
How did you hear about the Instruments for Science (I4S) program?
