Request GlycoMIP Scientific Services

Questions marked with a * are required
You must have completed a planning discussion with your Project Advocate to proceed.
Who is your assigned project advocate? 
You must have completed a planning discussion with your Project Advocate to proceed.Who is your assigned project advocate? 
The use of GlycoMIP facilities requires data collection and reporting to the National Science Foundation.  Please answer all questions in the form below to support GlycoMIP’s reporting requirements.
Basic Information (for Principal Investigator)
First name
Last Name
E-mail address
Telephone Number
Institution/Organization
Department
Position Title
Billing Address (Include Department/Institution)
Based on your communication with your Project Advocate, is this request a Service/Sample Request or a Project Proposal?
Based on your communication with your Project Advocate, is this request a Service/Sample Request or a Project Proposal?
Organization type 
Organization type 
Tentative Project Title
Brief Description of Project
Is this work non-proprietary or proprietary?
Is this work non-proprietary or proprietary?
Is this work domestic or international?
Is this work domestic or international?
Major source of Non-MIP funding
Major source of Non-MIP funding
Please provide the award number for the major source of Non-MIP funding

In addition to the PI, is there a primary scientific contact we should communicate with?

Contact email address
Contact Institution/Organization
Contact Position Title
Contact name
Will the PI come on-site to use the GlycoMIP facilities?
Will the PI come on-site to use the GlycoMIP facilities?
Will any collaborators come on-site to use the GlycoMIP facilities?
Will any collaborators come on-site to use the GlycoMIP facilities?
How many other collaborators are there?
How many other collaborators are there?
On a separate line for each participant, please enter their first and last name, email address and collaborative role.
 
GlycoMIP strives to reach a broad and diverse audience through all its programs. In support of this goal, we are collecting data from participants. Please help us by completing these optional questions. Your responses will remain confidential.
Please select an ethnicity or race for the PI (Optional, can select multiple)
Gender for the PI (Optional, please select one)
Gender for the PI (Optional, please select one)
Do you report having a disability? (For the PI, Optional, pease select one)
Do you report having a disability? (For the PI, Optional, pease select one)
Please download the following GlycoMIP Policy Acceptance or Service Agreement and upload on the next page. If you do not see an agreement in the block below, you have not completed the information necessary above.  Agreements are also available at https://glycomip.org/user-portal/
Use of the GlycoMIP user facility comes with requirements, including, but not limited to, acknowledgment of the MIP, publication, intellectual property rights and payment of required fees.  The PI must read and agree to the GlycoMIP Policy Acceptance before a project can start. Review and sign the policy.
 
Use of the GlycoMIP user facility comes with requirements, including, but not limited to, acknowledgment of the MIP, publication, intellectual property rights and payment of required fees.  The PI must read and agree to the GlycoMIP Service Agreement for Proprietary and/or International Work before a project can start.  Review and sign the policy.  
GlycoMIP Service Agreement for Proprietary and/or International Work - VT Only 
Use of the GlycoMIP user facility comes with requirements, including, but not limited to, acknowledgment of the MIP, publication, intellectual property rights and payment of required fees.  The PI must read and agree to the GlycoMIP Service Agreement for Proprietary and/or International Work before a project can start.  Review and sign the policy.  
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