Microscopy Training Request
Please submit this form to request training
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First Name *
Last Name *
Preferred pronouns? (what's this? -see https://www.mypronouns.org/ )
Email (Please enter your @ucsc.edu email if you have one) *
Please provide your Microscopy User ID if you have one.  Leave this blank if you do not.
P.I. First Name *
P.I. Last Name *
Role *
If you are Undergrad working under a Post-doc, or Graduate Student, please provide the name of the person you are working under.
Please provide a brief description of your sample *
What question are you trying to answer?
Is your sample live or fixed? *
Have you received any of the following safety training?  Select all that apply. *
Required
How will your sample be mounted? *
What mounting media do you intend to use?
Approximately how thick will your sample be? *
What dyes/fluorescent proteins do you intend to use to label your sample? *
What kind of microscope training are you currently seeking? Select all that apply. *
Required
When will you have samples ready to image? Please provide approximate date. *
Please provide 3-4 dates AND TIMES that you are available for training in the next 10 days.  

Note: Widefield training typically takes 2.5 - 4 hours depending on the scope & application.  Please allow 4 hours for confocal training.  

If you would like to train with other members of your lab, please coordinate your responses with them. 
*
Additional Comments?
Microscope
TO BE COMPLETED BY THE MICROSCOPY FACILITY MANAGER
Training Date
TO BE COMPLETED BY THE MICROSCOPY FACILITY MANAGER
MM
/
DD
/
YYYY
Microscope 2
TO BE COMPLETED BY THE MICROSCOPY FACILITY MANAGER
Training Date 2
TO BE COMPLETED BY THE MICROSCOPY FACILITY MANAGER
MM
/
DD
/
YYYY
Microscope 3
TO BE COMPLETED BY THE MICROSCOPY FACILITY MANAGER
Training Date 3
TO BE COMPLETED BY THE MICROSCOPY FACILITY MANAGER
MM
/
DD
/
YYYY
Microscope 4
TO BE COMPLETED BY THE MICROSCOPY FACILITY MANAGER
Training Date 4
TO BE COMPLETED BY THE MICROSCOPY FACILITY MANAGER
MM
/
DD
/
YYYY
Microscope 5
TO BE COMPLETED BY THE MICROSCOPY FACILITY MANAGER
Training Date 5
TO BE COMPLETED BY THE MICROSCOPY FACILITY MANAGER
MM
/
DD
/
YYYY
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