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BL12-1
MFX
RoboSync
BioSync
SAXS
XAS
SMB
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SSRL
LCLS
SLAC
Stanford
NIGMS
NIH
BER Portal
BER
DOE
Macromolecular Crystallography
at the Stanford Synchrotron Radiation Lightsource
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Shipping Samples to SSRL
General Information
Your Name
*
Institution
*
Phone
*
Access Information
Type of Access
Assigned Beam Time
BeamlineXpress/FCFS
Staff Collaboration
Access Additional Information
Assigned Beamline
BL12-1
BL12-2
BL9-2
BL14-1
BL7-1
Screening Program
Leave at SSRL Shipping and Receiving
Leave at MC Long Term Storage
BL9-3 (XAS)
BL4-2 (SAXS)
LCLS-MFX Standard Goniometer Setup
Preferred Beamline(s)?
*
BL12-1
BL12-2
BL9-2
BL14-1
BL7-1
Name of Collaborator
*
- Select -
Aina Cohen
Tzanko Doukov
Irimpan Mathews
Silvia Russi
Clyde Smith
Mike Soltis
Jeney Weirman
Proposal Number
*
Date of Experimental Start
Are You the Spokesperson on the Proposal?
Yes
No
Proposal Spokesperson's Name
*
Sample Information
Number of Liquid Nitrogen Dewars
0
1
2
3
4
5
6
7
8
9
10+
Total Number of Cassettes
0
1
2
3
4
5
6
7
8
9
10+
Total Number of Uni-Pucks
0
1
2
3
4
5
6
7
8
9
10+
Number of Blue Shipping Containers for Elevated Temperature
0
1
2
3
4
5
6
7
8
9
10+
Temperature Inside Blue Shipping Containers
*
5 degrees
20 degrees
Total Number of Elevated Temperature Plates
*
0
1
2
3
4
5
6
7
8
9
10+
International Shipments
Is this an International Shipment?
Yes
No
Are you Working with Tigers USA?
*
Yes
No
Read about US Customs delays in the
Shipping Samples Manual
Remote Information
Is this a Remote Experiment?
*
Yes
No
Do you want to Generate Return Shipping Request Forms Now?
*
Yes
No
Return Samples Request
Return Delivery Contact
Name
*
Phone
*
Return Ship To Information
Name
*
Institution
*
Address Line 1
*
Address Line 2
City
*
State/Province
*
Zipcode
*
Country
*
Return Shipment Payment
Carrier
*
FedEx
UPS
Other
Fedex Account Number (9 digits only)
*
Fedex Options
*
Ground
Overnight
International
UPS Account Number (6 digits only)
*
UPS Options
*
Ground
Overnight
Account Information
*
Insurance
*
Yes
Decline
Declare Value (USD)
*
$
Agreement Signature
Agreement Contents Dewar Assigned Beam Time
*
I certify that dewar(s) contain only liquid nitrogen and less than 50 mg of protein or class I biohazard.
Agreement Contents Dewar BeamlineXpress
*
I certify that dewar(s) contain only liquid nitrogen, less than 50 mg of protein and no biohazards. No proprietary research will be performed.
Agreement Contents Containers Assigned Beam Time
*
I certify that blue shipping containers contain less than 50 mg of protein and no biohazards.
Agreement Contents Containers BeamlineXpress
*
I certify blue shipping containers contain less than 50 mg of protein and no biohazards. No proprietary research will be performed.
Customs Delay
*
I acknowledge that by not using Tigers USA, this shipment may be delayed at US Customs.
Export Control
*
I certify that I have read, concur with and carried out the terms, conditions and requirements for export as outlined in the
Instructions for International Shipments.
Power of Attorney
*
I certify that I have sent a Power of Attorney Form to SSRL.
E-mail Signature
*
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