Researcher Application Form

In addition to submitting this webform, please e-mail your CV to Vikky Dauciunas, FHL Facilities Coordinator. If you would like to submit more information than is permitted in the form below, please e-mail it as a separate attachment (pdf, doc, txt).

First   Last

Role

What quarter are you applying for?

Academic title:

Highest degree:

Year degree awarded:

Degree earned at:

Institutional Mailing Address
Institution  
Department  
Street & Number
Street Address 2
City
State
Zip/Postal
Country
Office phone
Fax
Cell phone
E-mail address

 

Home Mailing Address
Street Address
City
State
Zip / Postal code
Country
Home phone (optional)

 

Options for housing assignments: apartments, cottages, mobile home, duplexes, huts (single or double occupancy), dormitory or off-campus. (Those who plan to bring pets must live off campus or board their pets at a local kennel. Persons living in dorms or huts are required to eat in the Dining Hall).

Requested housing space  
Arrival date mo/dy/year (e.g. 05/28/2008)
Departure date mo/dy/year (e.g. 07/31/2008)

If you expect to bring a research assistant(s), please list name(s) and have each RA submit this same Application for Research Facilities information for themselves. Please indicate if you will pay for the RA's expenses for housing, or lab space, or meals, or stockroom charges, or copies.

 

If you are applying for space as a Research Assistant, who is your supervisor?

Name of companion or spouse who will accompany you (your answer helps us sort mail and answer phones).

Will you be accompanied by children? Number? Ages?

If you require bedding (sheets, pillowcase, please indicate the number of bed kids you will need.

Payment information:

Your payment method
UW Budget #, if any  

RESEARCH REQUIREMENTS  

Please specifically indicate your needs for each of the following:

Animal or plant specimens you'll want to collect at FHL. Please indicate names, numbers and amounts required.

Do you plan to bring in any species which are not native to the San Juan Islands?


Please indicate names and numbers of any non-native organisms you plan to bring in. The Washington State Department of Fisheries and the WA Department of Wildlife require permits for importation of marine organisms into Washington and may refuse permission or require strict quarantine. Advanced notice of plans for imports is necessary.

Kind of laboratory space? Do you require indoor or outdoor aquaria?


Special equipment you do not expect to provide.

Unusual amounts and/or kinds of laboratory glassware or chemicals.

 

Do you plan to use the scanning or transmission electron microscope?



Do you plan to use radioisotopes in connection with your proposed work?



Anyone intending to SCUBA dive at the Labs must obtain permission with the Dive Safety Officer, Pema Kitaeff, at least 6 weeks prior to planned dives either to obtain permission via reciprocity or to begin the scientific certification process. All diving under UW auspices is conducted according to AAUS scientific diving standards (there is no recreational diving on the premises). See http://depts.washington.edu/fhl/boatdive and http://www.ehs.washington.edu/rbsdiving/ for more information about UW diving. Do you plan to use SCUBA in connection with your proposed research?


Do you plan to use FHL boats in connection with your proposed research?


Researchers intending to work with fishes or other vertebrates are required to submit a project proposal to the Institutional Animal Care and Use Committee of the University of Washington. Please submit your application to the UW ACC directly, with e-mail copy to Craig Staude at the time of your application. Do you plan to use vertebrates in connection with your proposed research?


RESEARCH DESCRIPTION

Please provide a short description (250 words or less) of your research interests and outline in brief your plans for work to be carried out at the Friday Harbor Laboratories. In particular, it is helpful to know your short and long term objectives.

Please provide a short description of your research interests for publication on the FHL web site and FHL Bulletin. Note that a description is required and is limited to 100 characters (including spaces). Example: "Investigations of nitric oxide signaling pathways in deuterostomes."

If you are applying for Research Facilities at Friday Harbor Laboratories for the months of June and July, please answer the following questions. In recent years we have received more applications then can be accomodated during these months. The answers to these questions (1,a,b,c) will assist us in prioritizing requests.

1. Is it possible for you to visit Friday Harbor Laboratories some other time besides the months of June and July? If not, please elaborate on the reasons below (or add your own reason).

a. Due to the species involved, the research I would like to conduct can only be done at FHL in June/July (as specified in my application), because...

b. Due to the species involved, the research I would like to conduct can only be done at FHL, and June/July (as specified in my application) is the only time I can be in Friday Harbor because...

c. I would like to conduct my research at FHL because... (fill in your reason below) and I can only arrange my schedule for June/July (as specified in my application) because...

If you have a personal webpage, please indicate the URL:

Please e-mail the following two documents as attachments (pdf or doc) to Vikky Dauciunas

1. Your CV.

2. Grants & publications, specifically:

a) your published or in-press studies of the last few years from your laboratory related to the research you intend to pursue at the Labs, and indicate which of these were directly or indirectly supported by earlier visits to the Friday Harbor Laboratories.

b) any grants or other funding that will support this research, and which have supported your recent research at FHL.


By submitting this form, I certify that the above information is complete and accurate. I acknowledge that failure to disclose complete and accurate information may result in denial of admission or dismissal from the University. I acknowledge that physical injury and death are risks inherent in the use of these facilities, and I assume all associated risks and I agree not to claim against the University for those risks. I agree to hold the University of Washington harmless from any and all injuries, damages and liabilities that may occur in the course of my visit, except for negligent acts or omissions of the University or its employees, students or agents acting in the scope of their duties.

By submitting this form, I agree to follow all Environmental Health and Safety rules at the University of Washington.
https://www.ehs.washington.edu/pso/index.shtm

These rules are explained in detail on the Laboratory Safety Checklist at the EH&S website http://www.ehs.washington.edu/fsosurveys/prvaslbchklst.pdf.

For a further explanation of each requirement click on the associated hot text on the Checklist. These requirements include Chemical Management, Standard Operating Procedures (SOP), and Personal Protective Equipment (PPE) for research done in my laboratory at FHL. I verify that I will follow all of the instructions on the Laboratory Safety Checklist while at FHL.

The University of Washington reaffirms its policy of equal opportunity in education regardless of race, color, creed, religion, national origin, sex, sexual orientation, age, marital status, disability, or status as a disabled veteran or Vietnam era veteran in accordance with University policy and applicable federal and state statutes and regulations.

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