BMB FV3000 Registration Form

Required fields are marked with an asterisk (*).

Personal Details

Full Name *

Position *

• Undergraduate or Honours Student
• MSc or PhD Student
• Research Staff (e.g. Causal staff, Research Assistant or Lab manager)
• Postdoctoral research staff (e.g. Research Fellow, lab head)

Email *

Phone *

Supervisor's Full Name *

Department (or Institute if not UoM) *

Instrument training request

I would like to be trained on the following instrument(s) *

• FV3000

Experience level *

• Novice
• Intermediate
• Expert

Please provide some details on your project. Please be as detailed as possible (e.g. sample, stains, image analysis required). The more we know, the more we can assist you in getting it right!! *

Charging Details

Affiliation *

• University of Melbourne (Must provide an active Themis code below)
• Monash University (Must provide a purchase order number)
• External user (Must provide invoice details and address)

Themis code (xx-xxxx-xx-7236-xxxxxx-xxx-xx-xx), Invoice details or PO number *

Documentation submission

I have read and understood the FV3000 SOP & RA *

• I confirm

User Agreement form signed by supervisor (Max file size = 1Mb) *

Competency Assessment (Max file size = 1Mb) *

Individual Training Record * Please ensure that all four sections have been completed

OGTR agreements *

What agreement is your project carried out under?

• Exempt dealing
• NLRD
• DNIR

NLRD work: Please upload your SOP & RA

Press SUBMIT only ONCE. It takes some time to upload the files. If you have any issues, please email the forms to bomp-enquiries@unimelb.edu.au

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