DND-CAT Beamline Request Form

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  Experimenter Information
    Spokesperson
    Other experimenters

  Requested Stations and Times
    Station request
    Time request

  Experiment Information
    Description
    Materials
    Requirements

Comments

Experimenter Information

Spokesperson

Name	E-mail

Institution
	list if other

Address

Telephone	Fax

Other experimenters

Requested Stations and Times

Station request

Name	Institution
		list if other

1st Choice	5BM			5ID
1st Choice	B	C	D	B	C	D	Assigned
2nd Choice	5BM			5ID
2nd Choice	B	C	D	B	C	D	Assigned

Time request

Desired Dates
Unacceptable Dates

Number 8 hour shifts

Total

Minimum

	Contiguous
	if yes explain

Experiment Information

Description

Title

Work is classified

Experiment Subject(s)

specify if other

Funding Source(s)

specify if other

Abstract

Materials

Name	Quant	CAS#	Hazard- ous	Known Hazards					Dispose at ANL
				Toxic	Bio- hazard	Flamm- able	Radio- active	Other

Special Sample Environment considerations

This experiment will use/require	human subjects/material
	live animals
	on-site chemical preparation

Requirements

Energy/Wavelength Range(s)	Energy Resolution

Detector system

Other Equipment/Materials to be Provided by DND-CAT

Equipment to be brought by user

Non-permanent equipment (user or DND-CAT) that will be used
cryogenics	furnace	high pressure
laser	high voltage	non-UL electrical

Laboratory Access and Space Requirements

Computer Security

Comments

User Comments: Use this space for any additional clarification required