Access form for the CERM/CIRMMP Cryo-EM instrumentation
Fields marked with
*
are required
Project
*
Title of Project
Please enter the project title.
*
Principal Applicant
*
First Name
Please enter the principal applicant first name.
*
Last Name
Please enter the principal applicant last name.
*
Nationality
Please enter the principal applicant nationality.
*
Institution
Please enter the principal applicant institution.
*
Phone Number
Please enter the principal applicant phone number.
*
Email
Please enter the principal applicant email address.
Remember to also fill out the Visiting Scientist section below
*
Visiting Scientist
Flag if the Applicant and Visiting scientist are the same person.
*
First Name
Please enter the visiting scientist first name.
*
Last Name
Please enter the visiting scientist last name.
*
Nationality
Please enter the visiting scientist nationality.
*
Institution
Please enter the visiting scientist institution.
*
Phone Number
Please enter the visiting scientist phone number.
*
Email
Please enter the visiting scientist email address.
Project Proposal
*
Project goals, background information and time planning (max 2500 chars)
Please enter the project goals....
*
Project status (results, related pubblications, grant applications) (max 2500 chars)
Please enter the project status.
*
Expected results (max 2500 chars)
Please enter the expected results.
Additional information (Document format accepted: pdf, doc, docx, odt - max size 5MB)
Sample Information
*
Protein(s) Uniprot ID
Please enter the protein uniprot ID.
*
Sample MW (kDa)
Please enter the sample MW.
Oligomeric state
Known symmetry
*
Concentration (mg/ml)
Please enter the sample concentration.
*
Buffer composition
Please enter the buffer composition.
*
SDS-PAGE
* Choose SDS-PAGE file...
Please select a sds-page file.
Attach JPG or PDF of scanned SDS-PAGE of sample to be used. Please name the file:
Attach_SDSPAGE.jpg or .pdf
Have you already performed negative staining EM on this sample?
YES
NO
NS Micrograph
* Choose NS Micrograph file...
Please select a NS Micrograph file.
Attach JPG or PDF of representative micrograph. Please name the file:
Attach_NS_Micrograph.jpg or .pdf
Have you already performed cryo-EM on this sample?
YES
NO
CEM Micrograph
* Choose CEM Micrograph file...
Please select a CEM Micrograph file.
Attach JPG or PDF of representative micrograph. Please name the file:
Attach_CEM_Micrograph.jpg or .pdf
After the measurements, would you like to dispose the sample?
YES
NO
*
Your sample will be sent back or store for 3 weeks under liquid nitrogen and then dispose (please specify)
Please enter information for the sample disposition.
*
Grid Type
Cu
Select at least a grid type.
Au
Select at least a grid type.
Ni
Select at least a grid type.
*
Requested Services
Cryo-EM specimen vitrification on Vitrobot MkIV
Select at least a service.
Cryo-EM grids screening
Select at least a service.
Cryo-EM data collection on Glacios CryoTEM (>= 24 slots)
Select at least a service.
Indicate Technique
Single-particle analysis
Tomography
Select technique
Timeslot and Additional Info
*
Would you need assistance for vitrification and/or clipping?
YES
NO
N.B.: by asking for assistance the user agrees to release FloCEN team members from any liability in case of sample preparation outcome not meeting expectations.
*
Indicate preferred time slot (e.g. 6 – 12 July)
Please enter a preferred timeslot.
*
Expected Outcome (max 2500 chars)
Please enter a expected outcome.
Additional info (max 2500 chars)
Do you plan to attend the experiment?
YES
NO
Yes, I read the lab regulation on
safety sheet
N.B.: after the experiment, data can be copied on your external USB devices. Please note that data will be stored on our server for
1 month only
, afterwards data will be erased.
*
AntiSpam
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Please enter the result of the sum.
Submit Request